Individual
DR. JEREMY STEWART SIBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10 TYLER DR, ESSEX JUNCTION, VT 05452-4639
(802) 316-6379
Mailing address
10 TYLER DR, ESSEX JUNCTION, VT 05452-4639
(802) 316-6379
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104.0000167
VT
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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