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Organization
VERNON INTEGRATIVE MEDICAL GROUP, LLC
Active
Organization
VERNON INTEGRATIVE MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON TRISTER MD (OWNER)
(508) 754-9950
Entity
Organization
Contact information
Practice address
141 MASSASOIT RD, WORCESTER, MA 01604-3318
(508) 754-9950
(508) 754-2592
Mailing address
141 MASSASOIT RD, WORCESTER, MA 01604-3318
(508) 754-9950
(508) 754-2592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
80587
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3144941
—
MA
Enumeration date
07/31/2013
Last updated
07/31/2013
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