Justin Yates Crockett
Specialist in Brattleboro, VT. Individual provider (NPI-1).
NPI number1003377151
StatusActive
Last updated in NPPESJul 16, 2024
Details
- NPI
- 1003377151
- Entity type
- Individual (NPI-1)
- Name
- Justin Yates Crockett
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2019
- Last updated
- Jul 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
51 FairviewstreetBrattleboro, VT 05301-2579
Phone 802-254-6028 · Fax 802-254-7501
Mailing address
390 River StreetSpringfield, VT 05156-2226
Phone 802-886-4500 · Fax 802-886-4520
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All 8 Specialist providers in Brattleboro · All 873 providers in Brattleboro
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