Healthcare Provider Details

I. General information

NPI: 1811205503
Provider Name (Legal Business Name): JMS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 05/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 IDX DR STE 220
SOUTH BURLINGTON VT
05403-7781
US

IV. Provider business mailing address

41 IDX DR STE 220
SOUTH BURLINGTON VT
05403-7781
US

V. Phone/Fax

Practice location:
  • Phone: 802-448-3388
  • Fax: 802-448-3387
Mailing address:
  • Phone: 802-448-3388
  • Fax: 802-448-3387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0910000176
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0990000131
License Number StateVT

VIII. Authorized Official

Name: MICHAEL STADTMAUER
Title or Position: MANAGING MEMBER
Credential: ND
Phone: 802-448-3388