Provider First Line Business Practice Location Address:
111 COLCHESTER AVE.
Provider Second Line Business Practice Location Address:
UVM MEDICAL CENTER/SURGERY, NEUROSURGERY
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:
802-847-4590
Provider Business Practice Location Address Fax Number:
802-847-0654
Provider Enumeration Date:
09/29/2006