| NPI | 1477935716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA L. YUKICA D.O./Practice Owner 802-222-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2019-09-25 |