Individual
COREY LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2559 GLEN RD, NEWPORT, VT 05855-9758
(802) 334-3364
Mailing address
164 LEADVILLE RD, NEWPORT CENTER, VT 05857-9495
(802) 272-7772
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0086261
VT
363A00000X
Physician Assistant
Primary
055.0031397
VT
Other
Enumeration date
12/07/2012
Last updated
09/13/2018
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