Individual
TERRY W. CANTLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 234-9913
(802) 728-2394
Mailing address
PO BOX 2000, RANDOLPH, VT 05060-2000
(802) 234-9913
(802) 728-2394
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0320000314
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006125
—
VT
Enumeration date
08/19/2006
Last updated
05/27/2014
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