| NPI | 1518180314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAYU BALU Medical Director 802-888-2448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: VT 042-0006455) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-06-26 |