Organization
MAD RIVER EYE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON HAWKLEY MITCHELL OD (MEMBER)
(802) 730-5167
Entity
Organization
Contact information
Practice address
5274 MAIN ST STE 1, WAITSFIELD, VT 05673-4445
(802) 730-5167
Mailing address
731 WORCESTER LOOP RD, STOWE, VT 05672-4326
(802) 730-5167
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
030.0068209
VT
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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