| NPI | 1750932646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON F LORD Medical Director 802-674-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |