Provider Demographics
NPI:1144596107
Name:KEARNS, MARGERY SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARGERY
Middle Name:SUE
Last Name:KEARNS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:PUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05346-0437
Mailing Address - Country:US
Mailing Address - Phone:503-939-2616
Mailing Address - Fax:
Practice Address - Street 1:133 MAIN ST RM 5
Practice Address - Street 2:
Practice Address - City:PUTNEY
Practice Address - State:VT
Practice Address - Zip Code:05346-9226
Practice Address - Country:US
Practice Address - Phone:802-536-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY719111N00000X
VT006.0098748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor