Individual
CLARENCE PAUL GRAETHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
655 MAIN ST, BENNINGTON, VT 05201
(802) 258-3905
(802) 258-4903
Mailing address
66 KNIGHT LN STE 10, WILLISTON, VT 05495-9308
(802) 873-4343
(802) 288-1144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0550030210
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OAP2257
—
VT
Enumeration date
05/09/2006
Last updated
03/22/2021
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