| NPI | 1336278985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY ANN VANDEWEERT Billing Manager 802-388-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2024-01-11 |