Individual
TRACY LEE COLLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44 SCHOOL ST, RANDOLPH, VT 05060-1150
(802) 728-5924
Mailing address
44 SCHOOL ST APT 2, RANDOLPH, VT 05060-1150
(802) 728-5924
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
025-0007981
VT
Other
Enumeration date
08/29/2008
Last updated
08/29/2008
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