Provider Demographics
NPI:1801213012
Name:JULIE SUAREZ CORMIER, LICAC, L3C
Entity Type:Organization
Organization Name:JULIE SUAREZ CORMIER, LICAC, L3C
Other - Org Name:VERMONT COMMUNITY ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:802-657-3700
Mailing Address - Street 1:2 CHURCH ST
Mailing Address - Street 2:SUITE 2J
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4299
Mailing Address - Country:US
Mailing Address - Phone:802-657-3700
Mailing Address - Fax:802-651-0756
Practice Address - Street 1:2 CHURCH ST
Practice Address - Street 2:SUITE 2J
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4299
Practice Address - Country:US
Practice Address - Phone:802-657-3700
Practice Address - Fax:802-651-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091.0000133171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty