Individual
DANIELLE MARIE LYSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
(802) 524-8915
Mailing address
17 DOON RD, UNDERHILL, VT 05489-9732
(028) 922-5150
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
104.0085244
VT
363A00000X
Physician Assistant
024052
NY
363A00000X
Physician Assistant
Primary
055.0031570
VT
Other
Enumeration date
04/17/2012
Last updated
01/23/2023
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