Healthcare Provider Details

I. General information

NPI: 1013088426
Provider Name (Legal Business Name): ASSOCIATES IN CHIROPRACTIC & KINESIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 SHELBURNE RD
BURLINGTON VT
05401-5008
US

IV. Provider business mailing address

507 SHELBURNE RD
BURLINGTON VT
05401-5008
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-5150
  • Fax:
Mailing address:
  • Phone: 802-864-5150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MRS. GINA R. MCLEAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 802-864-5150