Provider Demographics
NPI:1336760073
Name:ROYER, ZACHARY VICTOR
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:VICTOR
Last Name:ROYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BAXTER LN
Mailing Address - Street 2:
Mailing Address - City:BROWNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05860-9589
Mailing Address - Country:US
Mailing Address - Phone:802-673-2906
Mailing Address - Fax:
Practice Address - Street 1:117 BAXTER LN
Practice Address - Street 2:
Practice Address - City:BROWNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05860-9589
Practice Address - Country:US
Practice Address - Phone:802-673-2906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer