Provider Demographics
NPI:1700327673
Name:BATTENKILL VALLEY HEALTH CENTER
Entity type:Organization
Organization Name:BATTENKILL VALLEY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PRACTICE ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-430-7254
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-0061
Mailing Address - Country:US
Mailing Address - Phone:802-375-6566
Mailing Address - Fax:802-375-6828
Practice Address - Street 1:9 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250-4457
Practice Address - Country:US
Practice Address - Phone:802-375-6566
Practice Address - Fax:802-375-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.0000905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty