Individual
ALEXANDER SOULE-REGINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
60 AUSTIN DR, APT 2, BURLINGTON, VT 05401-5413
(978) 846-7097
Mailing address
60 AUSTIN DR, APT 2, BURLINGTON, VT 05401-5413
(978) 846-7097
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104.0112823
VT
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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