Individual
MS. JEANNE A PHILLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
77B PEARL ST, ESSEX JCT, VT 05452
(802) 878-5509
(802) 879-1350
Mailing address
PO BOX 14, ESSEX JCT, VT 05453
(802) 878-5509
(802) 879-1350
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0300000338
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN3881
—
VT
Enumeration date
05/15/2006
Last updated
02/13/2013
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