Individual
CARISSA ANN BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 GILLETTE STREET, WILDER, VT 05088-0863
(518) 424-7648
Mailing address
PO BOX 863, WILDER, VT 05088-0863
(518) 424-7648
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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