| NPI | 1336193838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GARDNER Finance Director 802-855-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-06-21 |