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General NPI Number Information
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NPI Number | 1962611764
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Entity Type | Organization
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Legal Business Name | BENNINGTON HANDS & FEET LLC DEBORAH A HENLEY SINGLE MBR
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 332 DEWEY ST
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City | BENNINGTON
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State | VT
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Zip | 05201-2225
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Country | US
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Telephone | 802-442-6314
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Fax |
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Provider Business Mailing Address
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Address Line | 332 DEWEY ST
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City | BENNINGTON
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State | VT
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Zip | 05201-2225
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Country | US
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Telephone | 802-442-6314
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DEBORAH A HENLEY
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Credential | M.D.
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Telephone | 802-442-1162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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