| Powerback Pediatrics Of Vermont, Llc | |
|
861 Williston Rd Ste 8 South Burlington VT 05403-5724 | |
| (888) 269-9876 | |
| Not Available |
| Full Name | Powerback Pediatrics Of Vermont, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 861 Williston Rd Ste 8, South Burlington, Vermont |
| Authorized Official Name and Position | John Cotcher (EVP OF PEDIATRICS) |
| Authorized Official Contact | 2486722593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Powerback Pediatrics Of Vermont, Llc 101 E State St Kennett Square PA 19348-3109 Ph: (888) 269-9876 | Powerback Pediatrics Of Vermont, Llc 861 Williston Rd Ste 8 South Burlington VT 05403-5724 Ph: (888) 269-9876 |
| NPI Number | 1609622067 |
|---|---|
| Provider Enumeration Date | 04/26/2024 |
| Last Update Date | 04/26/2024 |
| Certification Date | 04/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609622067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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