Individual
KATHRYN ANNE MACKSOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 RIVER ST, SPRINGFIELD, VT 05156-2930
(802) 886-8900
Mailing address
24 AIRPORT RD, WEST LEBANON, NH 03784
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031598
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/09/2022
Last updated
06/05/2022
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