Provider Demographics
NPI:1982252227
Name:CLEAR PATH CLINIC LLC
Entity Type:Organization
Organization Name:CLEAR PATH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAYA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:802-585-5968
Mailing Address - Street 1:147 STATE ST
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:147 STATE ST
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3301
Practice Address - Country:US
Practice Address - Phone:802-828-5968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty