| NPI | 1760157762 |
|---|---|
| Other Name | DOC POWDERED BY MARATHON HEALTH |
| Entity Type | Organization |
| Authorized Contact | JEFF WELLS CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-11 |