Individual
MICHAEL DIETRICH FETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
11 N MAIN ST, RANDOLPH, VT 05060-1126
(802) 728-4466
(802) 728-4197
Mailing address
6 CAMBRIDGEVILLE DR UNIT 4, ENFIELD, NH 03748-3160
(603) 345-6578
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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