| NPI | 1720267768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BROWN Billing Admin 802-257-0557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VT vt5482) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VT vt5482) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-10-26 |