Provider First Line Business Practice Location Address:
99 COURT ST
Provider Second Line Business Practice Location Address:
CEDAR LODGE FAMILY PRACTICE
Provider Business Practice Location Address City Name:
MIDDLEBURY
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05753-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-388-7185
Provider Business Practice Location Address Fax Number:
802-388-3445
Provider Enumeration Date:
07/20/2006