Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099-0000215 | VT |
NPI | 1013198555 |
---|---|
Provider Name | Dr. Samantha Kane Eagle |
First Address | Brattleboro, VT 05301-2867 |
Second Address | Brattleboro, VT 05301-2867 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2007 |
Last Update Date | 02/05/2014 |