Provider Demographics
NPI:1720322845
Name:GET HEALTHY VERMONT, PC
Entity Type:Organization
Organization Name:GET HEALTHY VERMONT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUBRY
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:TAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:866-638-4443
Mailing Address - Street 1:PMB 266: 150 DORSET STREET
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05443-6256
Mailing Address - Country:US
Mailing Address - Phone:866-638-4443
Mailing Address - Fax:
Practice Address - Street 1:368 DORSET ST
Practice Address - Street 2:SUITE 3
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6236
Practice Address - Country:US
Practice Address - Phone:866-638-4443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060001147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN3826Medicaid