# INTERVENTIONAL SPINE OF VERMONT, PLLC

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

## Provider details

- **NPI number:** 1497359103
- **Authorized official:** ESTHER CABALLERO-MANRIQUE MD (PHYSICIAN OWNER)
- **Authorized official phone:** (802) 404-2004

## Contact information

- **Practice address:** 277 BLAIR PARK RD STE 110, WILLISTON, VT 05495-7885
- **Practice address phone:** (802) 404-2004
- **Practice address fax:** (888) 506-2885
- **Mailing address:** PO BOX 1182, WILLISTON, VT 05495-1182
- **Mailing address phone:** (802) 404-2004
- **Mailing address fax:** (888) 506-2885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/23/2020
- **Last updated:** 12/03/2020