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Organization
WINOOSKI INTEGRATIVE MEDICINE PC
Active
Organization
WINOOSKI INTEGRATIVE MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM RUSSO ND,LAC, RMSK (PRINCIPAL)
(802) 636-4133
Entity
Organization
Contact information
Practice address
321 MAIN ST STE B, WINOOSKI, VT 05404-1380
(802) 636-4133
Mailing address
321 MAIN ST STE B, WINOOSKI, VT 05404-1380
(802) 636-4133
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
175F00000X
Naturopath
—
NULL
175F00000X
Naturopath
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/24/2022
Last updated
02/14/2025
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