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Organization
MAD RIVER EYE CARE PLLC
Active
Organization
MAD RIVER EYE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON HAWKLEY MITCHELL OD (MEMBER)
(802) 730-5167
Entity
Organization
Contact information
Practice address
5274 MAIN ST STE 1, WAITSFIELD, VT 05673-4445
(802) 730-5167
Mailing address
731 WORCESTER LOOP RD, STOWE, VT 05672-4326
(802) 730-5167
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
030.0068209
VT
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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