Individual
MISS CASEY LYNN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
174 RIVER ST, SUITE 102, MONTPELIER, VT 05602-3827
(802) 505-0597
(707) 440-4703
Mailing address
174 RIVER ST, SUITE 102, MONTPELIER, VT 05602-3827
(802) 505-0597
(707) 440-4703
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
099.0060043
VT
175F00000X
Naturopath
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017048
—
VT
Enumeration date
10/26/2009
Last updated
10/25/2011
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