| NPI | 1487602868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PITCHER Treasurer 802-860-1441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: VT 47D1068228) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2015-02-05 |