Individual
DR. SHAWN JAMES MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
86 DYLAN DR, SUITE 1, RANDOLPH, VT 05060-9619
(802) 728-5159
(802) 728-5199
Mailing address
86 DYLAN DR, SUITE 1, RANDOLPH, VT 05060-9619
(802) 728-5159
(802) 728-5199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0060001016
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38057
BLUECROSS BLUESHEILD VT
VT
05
—
OVN1716
—
VT
Enumeration date
08/23/2006
Last updated
09/15/2008
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