Healthcare Provider Details
I. General information
NPI: 1225446818
Provider Name (Legal Business Name): VERMONT VETERINARY CARDIOLOGY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2014
Last Update Date: 07/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
158 HURRICANE LN
WILLISTON VT
05495-2072
US
IV. Provider business mailing address
158 HURRICANE LN
WILLISTON VT
05495-2072
US
V. Phone/Fax
- Phone: 802-878-2022
- Fax: 866-627-0388
- Phone: 802-878-2022
- Fax: 866-627-0388
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174M00000X |
| Taxonomy | Veterinarian |
| License Number | 052.0001729 |
| License Number State | VT |
VIII. Authorized Official
Name: DR.
DONALD
J
BROWN
Title or Position: VETERINARIAN
Credential: D.V.M.
Phone: 802-477-2877