LISA M BLACK

BURLINGTON, VT
NPI1205098811
Former NameLISA BLOM
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: VT  055.0031258)
Enumeration Date2008-06-26
Last Update Date2017-04-03
Business Address
-- LISA M BLACK PA
111 COLCHESTER AVE UVM MEDICAL CENTER EMERGENCY DEPARTMENT
BURLINGTON, VT 05401-1473
Phone number: 802-847-0000
Mailing Address
-- LISA M BLACK PA
617 RIVERSIDE AVE
BURLINGTON, VT 05401-1601
Phone number: 802-864-6309
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