Healthcare Provider Details

I. General information

NPI: 1285423517
Provider Name (Legal Business Name): MR. PETER HENRY STRIFE III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SYLVAN RIDGE RD # X552
BONDVILLE VT
05340-4424
US

IV. Provider business mailing address

103 SYLVAN RIDGE RD # X552
BONDVILLE VT
05340-4424
US

V. Phone/Fax

Practice location:
  • Phone: 802-379-4501
  • Fax:
Mailing address:
  • Phone: 802-379-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number106354
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: