Individual
SPENCER CIANCOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 HOSPITAL DR STE 111, BENNINGTON, VT 05201-5010
(802) 440-4077
Mailing address
100 HOSPITAL DR, BENNINGTON, VT 05201-5004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031452
VT
Other
Enumeration date
06/21/2019
Last updated
12/26/2021
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