| NPI | 1235760653 |
|---|---|
| Other Name | LAITRAM HANOVER HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JERR FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |