| NPI | 1356971972 |
|---|---|
| Doing Business As | LAKE CHAMPLAIN REGEN MEDICAL |
| Entity Type | Organization |
| Authorized Contact | REBECCA E FIELDS Office Manager 802-734-9455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-23 |