Individual
LUCY E R SHORTSLEEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
215 STRATTON RD, RUTLAND, VT 05701-4621
(802) 773-3386
Mailing address
PO BOX 1599, PENOBSCOT COMMUNITY HEALTH CENTER, BANGOR, ME 04402-1599
(207) 945-5247
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1668
ME
Other
Enumeration date
04/19/2012
Last updated
05/28/2024
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