Provider First Line Business Practice Location Address:
111 COLCHESTER AVENUE
Provider Second Line Business Practice Location Address:
UVM MEDICAL CENTER, DEPT. OF MEDICINE
Provider Business Practice Location Address City Name:
BURLINGTON
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-847-8865
Provider Business Practice Location Address Fax Number:
802-847-7082
Provider Enumeration Date:
09/22/2006