MEDICARE: DR. SARAH ELIZABETH WYLIE ND

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	175F00000X	Naturopath	1536	OR
2	175F00000X	Naturopath	0990089283	VT

General Provider Information

NPI Number	:	1861667461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH ELIZABETH WYLIE ND

Provider Business Mailing Address
First Line	:	13 COMMON WAY
Second Line	:
City	:	CHARLOTTE
State	:	VT
Zip	:	05445-4426
Country	:	US
Telephone Number	:	971-998-2196
Fax Number	:	802-425-6241

Provider Business Practice Location Address
First Line	:	8 SHARD VILLA RD
Second Line	:
City	:	SALISBURY
State	:	VT
Zip	:	05769-9432
Country	:	US
Telephone Number	:	802-352-9078
Fax Number	:	802-352-1049

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

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	09/18/2012

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