Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 099.0124373 | VT |
Y | 208D00000X | General Practice Physician | 099.0124373 | VT |
NPI | 1053651760 |
---|---|
Provider Name | Dr. Christopher M. Deszynski |
First Address | Brattleboro, VT 05301-3909 |
Second Address | Brattleboro, VT 05301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2013 |
Last Update Date | 18/01/2019 |