Individual
MS. JANE PETERCUSKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82 ROUTE 15 WEST, HARDWICK, VT 05843
(802) 472-6961
(802) 472-8207
Mailing address
1060 TAYLOR RD, GREENSBORO BEND, VT 05842
(802) 533-9294
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00003461
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183500000X
PHARMACIST
VT
Enumeration date
06/13/2011
Last updated
06/13/2011
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