Individual
SAMANTHA M BOCKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
93 REYNOLDS RD, GRAND ISLE, VT 05458-2121
(802) 393-2401
Mailing address
93 REYNOLDS RD, GRAND ISLE, VT 05458-2121
(802) 393-2401
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
025.0135891
VT
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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