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General NPI Number Information
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NPI Number | 1891994794
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Entity Type | Organization
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Legal Business Name | VESTA, PLC
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 5247 SHELBURNE RD SUITE 204
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City | SHELBURNE
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State | VT
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Zip | 05482-7018
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Country | US
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Telephone | 802-985-3300
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Fax | 802-735-0454
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Provider Business Mailing Address
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Address Line | 5247 SHELBURNE RD SUITE 204
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City | SHELBURNE
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State | VT
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Zip | 05482-7018
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Country | US
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Telephone | 802-985-3300
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Fax | 802-735-0454
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY C SPICER
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Credential | DC
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Telephone | 802-985-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0060000899
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License Number State | VT
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