| NPI | 1295193803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE J RYAN President 802-886-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VT 006.0000733) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-02-10 |