Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099.0133909 | VT |
NPI | 1033620240 |
---|---|
Provider Name | Dr. Tara Pollock |
First Address | South Burlington, VT 05403-7758 |
Second Address | Shelburne, VT 05482-6690 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2017 |
Last Update Date | 14/10/2017 |