Individual
KENYON CASTLE BOLTON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 FISHER RD, BARRE, VT 05641-9004
(802) 371-4100
Mailing address
PO BOX 1456, MONTPELIER, VT 05601-1456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042.0015361
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2018
Last updated
07/21/2021
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