| NPI | 1790100246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN BAZAN Rehab Director 802-775-2941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VT 073.0000200) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2014-02-20 |