| Mountain Sports Medicine, Inc. | |
|
13 Grand Summit Way West Dover VT 05356 | |
| (802) 464-9300 | |
| (802) 464-9314 |
| Full Name | Mountain Sports Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 13 Grand Summit Way, West Dover, Vermont |
| Authorized Official Name and Position | Cheryl L. Rothman (BUSINESS MANAGER) |
| Authorized Official Contact | 8024649311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Sports Medicine, Inc. Po Box 207 West Dover VT 05356-0207 Ph: (802) 464-9300 | Mountain Sports Medicine, Inc. 13 Grand Summit Way West Dover VT 05356 Ph: (802) 464-9300 |
| NPI Number | 1285674994 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285674994 | NPI | - | NPPES |
| 0004530 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Vermont) | Primary |
Svmc Mountain Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13 Grand Summit Way, West Dover, VT 05356 Phone: 802-464-9300 Fax: 802-464-9314 |