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Individual

EARL BUMP JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
504 MAIN ST, SUITE 2, BENNINGTON, VT 05201-2111
(802) 442-9052
Mailing address
504 MAIN ST, SUITE 2, BENNINGTON, VT 05201-2111
(802) 442-9052

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
21209775
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1026752
VT
Enumeration date
11/22/2016
Last updated
11/22/2016
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