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1104209139
ALEXANDER SOULE-REGINE
BURLINGTON, VT
NPI
1104209139
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VT 104.0112823)
Enumeration Date
2015-07-08
Last Update Date
2015-07-08
Business Address
-- ALEXANDER SOULE-REGINE
60 AUSTIN DR APT 2
BURLINGTON, VT 05401-5413
Phone number: 978-846-7097
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Mailing Address
-- ALEXANDER SOULE-REGINE
60 AUSTIN DR APT 2
BURLINGTON, VT 05401-5413
Phone number: 978-846-7097
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