| Doctor Name: | DR. JONATHAN ERIC FENTON |
| NPI Number: | 1689688632 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 032-0000356 |
| Business Practice Address: | 321 Main St Suite C Winooski, VT - 054041335 |
| Business Phone Number: | 8028590000 |
| Business Fax Number: | 8028590005 |
| Mailing Address: | 321 Main St, Suite C WINOOSKI |
| State: | VT |
| Postal Code: | 054041335 |
| Phone Number: | 8028590000 |
| Fax Number: | 8028590005 |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 032-0000356 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |