| NPI | 1174901342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE C LOCKRIDGE Owner/ Sole Proprietor 802-334-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: VT 1010044793) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2020-06-22 |