| NPI | 1548892961 |
|---|---|
| Other Name | ST JOHNS O'CONNELL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-02-05 |