Organization
MAD RIVER INTEGRATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM WARGO (OWNER)
(802) 496-2202
Entity
Organization
Contact information
Practice address
5360 MAIN ST, SUITE 2, WAITSFIELD, VT 05673-6003
(802) 496-2202
Mailing address
5360 MAIN ST, SUITE 2, WAITSFIELD, VT 05673-6003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/24/2007
Last updated
10/27/2007
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