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Individual

PROF. GREGORY LAWRENCE EHLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MMSC, PA-C

Contact information

Practice address
111 COLCHESTER AVE, MCCLURE 1 CARDIOLOGY, BURLINGTON, VT 05401-1473
(802) 847-3352
(802) 847-8818
Mailing address
439 BIG HOLLOW RD, STARKSBORO, VT 05487-7273
(802) 453-3919

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0550030643
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009842
VT
Enumeration date
08/04/2006
Last updated
07/09/2007
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