Individual
ERICK JP LAVALLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44 MAIN ST, SUITE 200, RICHFORD, VT 05476-1153
(802) 255-5500
(802) 255-5509
Mailing address
44 MAIN ST, STE 200, RICHFORD, VT 05476-1141
(802) 255-5500
(802) 255-5589
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0010825
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00068325
BCBS
VT
05
—
1010984
—
VT
Enumeration date
09/30/2005
Last updated
01/15/2018
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