NPI 1003377151

Justin Yates Crockett

Practitioner Specialist Brattleboro, VT

Practice location

Address: 51 Fairviewstreet, Brattleboro, VT 05301-2579
Phone: (802) 254-6028
Fax: (802) 254-7501
Mailing address: 390 River Street, Springfield, VT 05156-2226

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1003377151
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Mar 2019
Record last updated: 16 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.