Healthcare Provider Details

I. General information

NPI: 1598741159
Provider Name (Legal Business Name): JAMES R. MCGLINN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 HARTFORD AVE SUITE C
WHITE RIVER JUNCTION VT
05001-8051
US

IV. Provider business mailing address

826 HARTFORD AVE SUITE C
WHITE RIVER JUNCTION VT
05001-8051
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-7725
  • Fax: 802-295-7726
Mailing address:
  • Phone: 802-295-7725
  • Fax: 802-295-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number060000638
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: