Healthcare Provider Details

I. General information

NPI: 1376191114
Provider Name (Legal Business Name): RUTLAND NATUROPATHIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 12/31/2023
Certification Date: 12/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 ALLEN ST STE 4
RUTLAND VT
05701-4564
US

IV. Provider business mailing address

69 ALLEN ST STE 4
RUTLAND VT
05701-4564
US

V. Phone/Fax

Practice location:
  • Phone: 802-772-7117
  • Fax: 802-488-5716
Mailing address:
  • Phone: 802-772-7117
  • Fax: 802-488-5716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY JOHN BURKLAND
Title or Position: NATUROPATHIC PHYSICIAN
Credential: ND
Phone: 802-772-7117