| NPI | 1861762742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE LEE CLARK Practice Manager 802-732-8054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VT 0060075005) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-01-09 |