Organization
TINA D'AMATO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA D'AMATO D.O. (PRESIDENT)
(508) 498-7242
Entity
Organization
Contact information
Practice address
71 KNIGHT LN, SUITE 10/20, WILLISTON, VT 05495-4432
(802) 872-7001
(802) 872-9088
Mailing address
71 KNIGHT LN, SUITE 10/20, WILLISTON, VT 05495-4432
(802) 872-7001
(802) 872-9088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0320000547
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014019
—
VT
Enumeration date
10/15/2010
Last updated
10/15/2010
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