Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 042.0013502 | VT |
NPI | 1134495054 |
---|---|
Provider Name | Timothy John Partridge |
First Address | Barre, VT 05641-0547 |
Second Address | Northfield, VT 05663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 11/08/2016 |