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Organization
MOUNTAINSIDE CHIROPRACTIC
Active
Organization
MOUNTAINSIDE CHIROPRACTIC
Active
Other names
Mountainside Community Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
BONNY R PAYNE (OWNER)
(802) 565-0424
Entity
Organization
Contact information
Practice address
321 ROUTE 113, EAST THETFORD, VT 05043
(802) 565-0424
Mailing address
PO BOX 154, EAST THETFORD, VT 05043-0154
(802) 565-0424
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
02/02/2021
Last updated
11/05/2023
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