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Individual

PAUL M LINDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1290 HOSPITAL DR, SUITE 5, ST JOHNSBURY, VT 05819-9239
(802) 748-8126
(802) 748-2208
Mailing address
773 SLATE LEDGE RD, LITTLETON, NH 03561-3432
(603) 444-5989

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0300000266
VT
152W00000X
Optometrist
0622
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0VN1122
VT
05
30008906
NH
01
RE5917
MEDICARE PTAN
NH
01
VN1122
MEDICARE PTAN
VT
Enumeration date
09/21/2005
Last updated
07/03/2013
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