Healthcare Provider Details

I. General information

NPI: 1720258064
Provider Name (Legal Business Name): CHAMPLAIN CENTER FOR NATURAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 SHELBURNE RD
SHELBURNE VT
05482-6690
US

IV. Provider business mailing address

3804 SHELBURNE RD
SHELBURNE VT
05482-6690
US

V. Phone/Fax

Practice location:
  • Phone: 802-985-8250
  • Fax: 802-985-3401
Mailing address:
  • Phone: 802-985-8250
  • Fax: 802-985-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. WILLIAM EARL WARNOCK
Title or Position: PRESIDENT
Credential: ND
Phone: 802-985-8250