| NPI | 1467806067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN CARLISLE MACKENZIE President 802-442-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: VT 420009174) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2022-06-17 |