| Mystan LLC | |
|
145 Pine Haven Shores Rd Ste 1000a Shelburne VT 05482-7812 | |
| (406) 309-6462 | |
| Not Available |
| Full Name | Mystan LLC |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 145 Pine Haven Shores Rd Ste 1000a, Shelburne, Vermont |
| Authorized Official Name and Position | Renato Namoc (OWNER) |
| Authorized Official Contact | 4063096462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mystan LLC 145 Pine Haven Shores Rd Ste 1000a Shelburne VT 05482-7812 Ph: (406) 309-6462 | Mystan LLC 145 Pine Haven Shores Rd Ste 1000a Shelburne VT 05482-7812 Ph: (406) 309-6462 |
| NPI Number | 1841112927 |
|---|---|
| Provider Enumeration Date | 07/29/2026 |
| Last Update Date | 07/29/2026 |
| Certification Date | 07/29/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841112927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
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