Provider Demographics
NPI:1538890769
Name:ROLON RESTO, ENIEL GERARDO (DC)
Entity type:Individual
Prefix:
First Name:ENIEL
Middle Name:GERARDO
Last Name:ROLON RESTO
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 ALLEN RD UNIT 215
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-3804
Mailing Address - Country:US
Mailing Address - Phone:787-216-5000
Mailing Address - Fax:
Practice Address - Street 1:356 MOUNTAIN VIEW DR STE 200
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5989
Practice Address - Country:US
Practice Address - Phone:802-655-2664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3786111N00000X
VT006.0134191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor