| NPI | 1295832400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE HODGE Office Manager 802-457-5405 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 703) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VT 703) |
| 207W00000X Ophthalmology (Licence: VT 703) | |
| 208000000X Pediatrics (Licence: VT 703) | |
| 207Q00000X Family Medicine (Licence: VT 703) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-11-01 |