Individual
KATHLEEN TALBOT SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1199 MAIN ST, FAIRFAX, VT 05454-9530
(802) 849-2844
Mailing address
44 MAIN ST STE 200, RICHFORD, VT 05476-1141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900841
—
VT
Enumeration date
03/31/2016
Last updated
11/19/2018
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