Provider Demographics
NPI:1780851873
Name:DR. VERNON R. TEMPLE
Entity Type:Organization
Organization Name:DR. VERNON R. TEMPLE
Other - Org Name:TEMPLE CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:R
Authorized Official - Last Name:TEMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-463-9522
Mailing Address - Street 1:633 RTE 121
Mailing Address - Street 2:
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101-1632
Mailing Address - Country:US
Mailing Address - Phone:802-463-9522
Mailing Address - Fax:802-463-1957
Practice Address - Street 1:633 RTE 121
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101-1632
Practice Address - Country:US
Practice Address - Phone:802-463-9522
Practice Address - Fax:802-463-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000655111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1124056825OtherINDIVIDUAL NPI NUMBER
VT0008772Medicaid
VT1124056825OtherINDIVIDUAL NPI NUMBER