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Organization

TACONIC ESSENTIAL PRIMARY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW TODD DAYTON CCMA (OWNER/ OFFICE MANAGER)
(802) 683-7790
Entity
Organization

Contact information

Practice address
79 CENTER ST STE 1-1, RUTLAND, VT 05701-4061
(802) 683-7790
Mailing address
79 CENTER ST STE 1-1, RUTLAND, VT 05701-4061
(802) 683-7790

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6712491
VT
Enumeration date
01/20/2025
Last updated
03/06/2025
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