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Organization

CHAMPLAIN VALLEY ANESTHESIA, PLLC

Active
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Organization

CHAMPLAIN VALLEY ANESTHESIA, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN L. IANNI MD (AUTHORIZED REPRESENTATIVE)
(802) 462-3225
Entity
Organization

Contact information

Practice address
115 PORTER DR, MIDDLEBURY, VT 05753-8423
(802) 388-4724
Mailing address
255 W MICHIGAN AVE, P.O. BOX 1123, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—

Other

Enumeration date
01/05/2011
Last updated
01/05/2011
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