# VERMONT INTERVENTIONAL SPINE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346459153
- **Authorized official:** TERE F BERRY MD (OFFICE MANAGER)
- **Authorized official phone:** (802) 655-9798

## Contact information

- **Practice address:** 356 MOUNTAIN VIEW DR, COLCHESTER, VT 05446-5985
- **Practice address phone:** (802) 658-9798
- **Mailing address:** 356 MOUNTAIN VIEW DR, SUITE 200, COLCHESTER, VT 05446
- **Mailing address phone:** (802) 655-9798
- **Mailing address fax:** (802) 655-0002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 05/11/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1013828 | — | VT |