Provider Demographics
NPI:1417049578
Name:FLETCHER ALLEN HEALTHCARE
Entity Type:Organization
Organization Name:FLETCHER ALLEN HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT/L HAND SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SONACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-847-4333
Mailing Address - Street 1:560 SUNDERLAND WOODS RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5894
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:792 COLLEGE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3052
Practice Address - Country:US
Practice Address - Phone:802-847-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0720000013282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital