| NPI | 1861690075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL G. BOERMAN Owner 802-860-6725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VT 0160000990) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-07-10 |