Healthcare Provider Details

I. General information

NPI: 1104881713
Provider Name (Legal Business Name): VERMONT ASSOCIATION FOR THE BLIND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 KIMBALL AVE
S BURLINGTON VT
05403-6808
US

IV. Provider business mailing address

60 KIMBALL AVE
S BURLINGTON VT
05403-6808
US

V. Phone/Fax

Practice location:
  • Phone: 802-863-1358
  • Fax: 802-863-1481
Mailing address:
  • Phone: 802-863-1358
  • Fax: 802-863-1481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN P. POULIOT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 802-863-1358