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General NPI Number Information
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NPI Number | 1750567806
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Entity Type | Organization
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Legal Business Name | THE MANE HOUSE
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 3097 WILLISTON RD THE MANE HOUSE
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-6044
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Country | US
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Telephone | 802-860-1099
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Fax | 802-651-4944
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Provider Business Mailing Address
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Address Line | 3097 WILLISTON RD THE MANE HOUSE
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403
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Country | US
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Telephone | 802-860-1099
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Fax | 802-651-4944
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LYNN M WILKINSON
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Credential |
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Telephone | 802-860-1099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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