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Organization
MYSTAN LLC
Active
Organization
MYSTAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENATO NAMOC (OWNER)
(406) 309-6462
Entity
Organization
Contact information
Practice address
145 PINE HAVEN SHORES RD STE 1000A, SHELBURNE, VT 05482-7812
(406) 309-6462
Mailing address
145 PINE HAVEN SHORES RD STE 1000A, SHELBURNE, VT 05482-7812
(406) 309-6462
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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