Twin River Urology

NPI #1205941879 in White River Jct, Vermont

Provider Information

NPI Number: 1205941879
Entity Type: Organization
Organization Name: Twin River Urology
Primary Specialty: Urology
Enumeration Date: Aug 21, 2006
Last Updated: Jul 17, 2007

Practice Location

Address: 108 NO MAIN ST
Address 2: TWIN RIVER UROLOGY
City: White River Jct
State: Vermont
ZIP Code: 05001
Phone: (802) 296-7370

Authorized Official

Name: MS. KATHY L DETZER
Title: BUS MANAGER
Phone: (802) 296-7370

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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