Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 104.0086022 | VT |
NPI | 1033474309 |
---|---|
Provider Name | Jennifer M Farrugia |
First Address | South Burlington, VT 05403-4484 |
Second Address | South Burlington, VT 05403-4484 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 11/07/2012 |