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Individual

MRS. MARCIA M BRISTOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS RD CD

Contact information

Practice address
128 LAKESIDE AVE, BURLINGTON, VT 05401-4939
(802) 777-9691
(802) 985-9947
Mailing address
3528 HARBOR RD, SHELBURNE, VT 05482-7795
(802) 777-9691
(802) 985-9947

Taxonomy

Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
0740076077
VT

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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