MEDICARE: ERIN J SEPIC D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	006-0001157	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	68834	OTHER	VT	BLUE CROSS PROVIDER ID
2	6602627	OTHER	VT	CIGNA PROVIDER ID

General Provider Information

NPI Number	:	1538255419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN J SEPIC D.C.

Provider Business Mailing Address
First Line	:	1151 W MAIN ST
Second Line	:
City	:	RICHMOND
State	:	VT
Zip	:	05477-4472
Country	:	US
Telephone Number	:	802-434-5437
Fax Number	:	802-329-2163

Provider Business Practice Location Address
First Line	:	1151 W MAIN ST
Second Line	:
City	:	RICHMOND
State	:	VT
Zip	:	05477-4472
Country	:	US
Telephone Number	:	802-434-5437
Fax Number	:	802-329-2163

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/29/2008

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