Individual
JEFFREY BLAINE WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
86 BAY ROAD, SHELBURNE, VT 05482
(802) 233-0202
Mailing address
86 BAY ROAD, SHELBURNE, VT 05482
(802) 233-0202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2474
VT
Other
Enumeration date
05/29/2008
Last updated
10/06/2013
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