Organization
LESLEY BRODIE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLEY THOMPSON BRODIE M.D. (OFFICER/MEMBER)
(802) 367-1068
Entity
Organization
Contact information
Practice address
82 ELM STREET, MANCHESTER CENTER, VT 05255-9642
(802) 367-1068
(802) 367-1069
Mailing address
PO BOX 766, MANCHESTER, VT 05254-0766
(802) 367-1068
(802) 367-1069
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
042.0012150
VT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
042.0012150
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019286
—
VT
Enumeration date
04/25/2014
Last updated
04/25/2014
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