| NPI | 1780969345 |
|---|---|
| Doing Business As | CHCRR PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL GARDNER Finance Director 802-855-2083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2017-01-18 |