| NPI | 1861876591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DANIEL HENLEY Owner 802-598-8334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 104.0113349) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |