=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063424380
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALLEY PATHOLOGY ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 BELMONT AVE
-----------------------------------------------------
City | BRATTLEBORO
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05301-6613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-257-8372
-----------------------------------------------------
Fax | 802-257-8287
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17 BELMONT AVE
-----------------------------------------------------
City | BRATTLEBORO
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05301-6613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-257-8372
-----------------------------------------------------
Fax | 802-257-8287
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. CHRISTOPHER APPLETON
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 802-257-8372
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | 032-506
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------