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General NPI Number Information
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NPI Number | 1518820851
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Entity Type | Organization
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Legal Business Name | WOODSTOCK HEALTH CLINIC PLLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 217 MAXHAM MEADOW WAY STE 3A
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City | WOODSTOCK
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State | VT
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Zip | 05091-1162
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Country | US
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Telephone | 802-324-1281
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Fax |
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Provider Business Mailing Address
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Address Line | 217 MAXHAM MEADOW WAY STE 3A
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City | WOODSTOCK
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State | VT
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Zip | 05091-1162
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Country | US
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Telephone | 802-324-1281
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Fax |
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Authorized Official
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Title or Position | OWNER / PA-C
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Name | MARJORIE GEWIRZ
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Credential | PA-C
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Telephone | 802-324-1281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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