Individual
LYNN W HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 BELMONT AVE, BRATTLEBORO, VT 05301-7110
(802) 258-3905
(802) 258-4903
Mailing address
600 BLAIR PARK RD, SUITE 190, WILLISTON, VT 05495-7586
(802) 872-4343
(802) 872-0282
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042-0005007
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN0732
—
VT
Enumeration date
01/31/2006
Last updated
06/06/2013
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