Healthcare Provider Details

I. General information

NPI: 1629512439
Provider Name (Legal Business Name): HOWARD CHIROPRACTIC ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SUMMER ST STE 101
ST JOHNSBURY VT
05819-2365
US

IV. Provider business mailing address

222 SUMMER ST STE 101
ST JOHNSBURY VT
05819-2365
US

V. Phone/Fax

Practice location:
  • Phone: 802-748-3166
  • Fax: 802-748-3435
Mailing address:
  • Phone: 802-748-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006.0102489
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number006.0000678
License Number StateVT

VIII. Authorized Official

Name: DR. TRAVIS M HOWARD
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 603-991-5682