| Organization Name: | VERMONT CENTER FOR OCCUPATIONAL REHABILIATION |
| NPI Number: | 1609128164 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN RUSSELL JOHANSSON (OSTEOPATHIC PHYSICIAN) |
| Mailing Address: | 67 Lincoln St Essex Junction |
| State: | VT US |
| Postal Code: | 054523235 |
| Phone Number: | 8028789700 |
| Fax Number: | 8028789966 |
| NPI Enumeration Date: | 10/09/2012 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | 032.0000304 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |