| NPI | 1689094039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE C LOCKRIDGE Sole Proprietor/Sole Owner 802-334-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VT 0420011226) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-10-28 |