Mad River Integrative Medicine
Family Medicine in Waitsfield, VT. Organization (NPI-2).
NPI number1124239199
StatusActive
Last updated in NPPESOct 27, 2007
Details
- NPI
- 1124239199
- Entity type
- Organization (NPI-2)
- Legal business name
- Mad River Integrative Medicine
- Organization subpart
- No
- Enumeration date
- May 24, 2007
- Last updated
- Oct 27, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
5360 Main StSuite 2
Waitsfield, VT 05673-6003
Phone 802-496-2202
Mailing address
5360 Main StSuite 2
Waitsfield, VT 05673-6003
Authorized official
Tim Wargo
Owner
8024962202
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Other Family Medicine Physician providers in Waitsfield, VT
- Francis W Cook, M.D.NPI 1700820115
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- Jennifer Selland, MDNPI 1518545383
- Nanette M Wessel Kissenberth, DONPI 1619133683
- John A Wilson, MDNPI 1013193093
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