NPI | 1619694478 |
---|---|
Entity Type | Organization |
Authorized Contact | SAM RUSSO Principal 802-922-5091 |
Organization Subpart ? | No |
Primary Taxonomy | 175F00000X Naturopath |
Additional Taxonomies | 171100000X Acupuncturist |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2022-10-24 |
Last Update Date | 2023-05-01 |