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General NPI Number Information
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NPI Number | 1164116968
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Entity Type | Organization
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Legal Business Name | HELIOS NATURAL MEDICINE PLLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 13 KILBURN ST
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City | BURLINGTON
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State | VT
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Zip | 05401-4750
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Country | US
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Telephone | 802-540-0066
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4586
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City | BURLINGTON
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State | VT
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Zip | 05406-4586
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Country | US
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Telephone | 802-540-0066
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SUSAN JACOBS
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Credential | ND
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Telephone | 513-646-2214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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