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General NPI Number Information
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NPI Number | 1720267768
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Entity Type | Organization
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Legal Business Name | VERMONT ENT ASSOCIATES, LTD
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 15 FAIRVIEW ST
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6629
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Country | US
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Telephone | 802-257-0557
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Fax | 802-257-5460
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Provider Business Mailing Address
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Address Line | 15 FAIRVIEW ST
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6629
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Country | US
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Telephone | 802-257-0557
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Fax | 802-257-5460
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Authorized Official
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Title or Position | BILLING ADMIN
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Name | MICHELLE BROWN
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Credential |
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Telephone | 802-257-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | VT5482
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | VT5482
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License Number State | VT
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