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Organization
BROOKSIDE FAMILY HEALTH CENTER, PLLC
Active
Organization
BROOKSIDE FAMILY HEALTH CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER JOSEPH GIROUX M.D. (OWNER)
(802) 482-3900
Entity
Organization
Contact information
Practice address
206 COMMERCE ST, HINESBURG, VT 05461-0416
(802) 482-3900
(802) 482-4159
Mailing address
PO BOX 416, 206 COMMERCE ST, HINESBURG, VT 05461-0416
(802) 482-3900
(802) 482-4159
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
42-0008119
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9210
—
VT
Enumeration date
09/05/2014
Last updated
09/05/2014
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