Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099-0000176 | VT |
NPI | 1114110137 |
---|---|
Provider Name | Dr. Christopher Edward Hollis |
First Address | Randolph, VT 05060-1363 |
Second Address | Randolph, VT 05060-1363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 22/08/2007 |