| NPI | 1376075804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT EVAN BENJAMIN Owner/Physician 802-522-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VT 420010625) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |