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1376170522
JACK CHAN
BURLINGTON, VT
NPI
1376170522
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-26
Last Update Date
2020-03-26
Business Address
Dr. JACK CHAN MD
111 COLCHESTER AVE
BURLINGTON, VT 05401-1473
Phone number: 802-847-2345
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Mailing Address
Dr. JACK CHAN MD
73 SPRAGUE ST
MALDEN, MA 02148-4035
Phone number: 617-372-4018
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