Organization Name:  TIMBER LANE ALLERGY & ASTHMA ASSOCIATES, PC


Practice Location:
53 TIMBER LN  SOUTH BURLINGTON, VT 05403 US
Tel: 802-864-0294  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology	VT

Other Provider Identifiers:

Issuer	Number	State	Type
BLUE CROSS BLUE SHIELD VT	28818	VT	01
TRICARE	TOO2520		01
	01398301	NY	05
	0VN1324	VT	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin