Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 030.0121630 | VT |
NPI | 1013441666 |
---|---|
Provider Name | Craig Volpe |
First Address | Williston, VT 05495-5321 |
Second Address | Williston, VT 05495-5321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2017 |
Last Update Date | 19/04/2017 |