Healthcare Provider Details

I. General information

NPI: 1487987400
Provider Name (Legal Business Name): NCV PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4076 SHELBURNE RD STE 5
SHELBURNE VT
05482-6676
US

IV. Provider business mailing address

4076 SHELBURNE RD STE 5
SHELBURNE VT
05482-6676
US

V. Phone/Fax

Practice location:
  • Phone: 802-985-9850
  • Fax: 802-985-3711
Mailing address:
  • Phone: 802-985-9850
  • Fax: 802-985-3711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number994
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number994
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number994
License Number StateVT
# 4
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number994
License Number StateVT
# 5
Primary TaxonomyN
Taxonomy Code111NT0100X
TaxonomyThermography Chiropractor
License Number994
License Number StateVT

VIII. Authorized Official

Name: MS. SARAH DUNN
Title or Position: GENERAL MANAGER
Credential:
Phone: 802-985-9850