| NPI | 1720125313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL J. GARDNER Physician 802-879-6544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VT 032-000053) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2011-11-16 |