Organization
CHAMPLAIN VALLEY ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L IANNI MD (AUTHORIZED REPRESENTATIVE)
(802) 462-3225
Entity
Organization
Contact information
Practice address
115 PORTER DR, MIDDLEBURY, VT 05753-8423
(802) 388-4724
Mailing address
519 ROBBINS RD, CORNWALL, VT 05753-9236
(802) 462-3225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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