| NPI | 1790305985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD LIBRATY Owner 802-391-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2021-10-08 |