# VERMONT CENTER FOR REGENERATIVE MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Champlain Regen Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356971972
- **Authorized official:** REBECCA E FIELDS (OFFICE MANAGER)
- **Authorized official phone:** (802) 734-9455

## Contact information

- **Practice address:** 71 KNIGHT LN STE 20, WILLISTON, VT 05495-4514
- **Practice address phone:** (802) 734-9455
- **Practice address fax:** (678) 574-5605
- **Mailing address:** 71 KNIGHT LN STE 20, WILLISTON, VT 05495-4514
- **Mailing address phone:** (802) 734-9455
- **Mailing address fax:** (678) 574-5605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/23/2020
- **Last updated:** 01/23/2020