Individual
GEORGE MARTIN CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MHP
Contact information
Practice address
1436 EXCHANGE ST, MIDDLEBURY, VT 05753-1185
(802) 388-3194
(802) 388-4881
Mailing address
1436 EXCHANGE ST, MIDDLEBURY, VT 05753-1185
(802) 388-3194
(802) 388-4881
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0550030564
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001415
—
VT
Enumeration date
10/06/2005
Last updated
12/23/2009
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