Individual
MR. ALAN MICHAEL MAYNARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
213A PATRICK GYMNASIUM, 97 SPEAR ST., BURLINGTON, VT 05405-0001
(802) 656-7678
Mailing address
42 CRYSTAL RD, FAIRFAX, VT 05454-9572
(802) 656-7678
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1040000092
VT
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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