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General NPI Number Information
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NPI Number | 1407624596
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Entity Type | Organization
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Legal Business Name | GREEN MOUNTAIN HOLISTIC HEALING PLC
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 481 BROOKLYN ST
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City | MORRISVILLE
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State | VT
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Zip | 05661-8510
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Country | US
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Telephone | 802-477-2577
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1516
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City | MORRISVILLE
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State | VT
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Zip | 05661-1516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA COOK
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Credential |
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Telephone | 802-477-2577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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