Organization
MAPLE TREE GENERAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD LEE JIMMO MD (SURGEON)
(802) 775-7745
Entity
Organization
Contact information
Practice address
215 STRATTON RD, RUTLAND, VT 05701-4621
(802) 775-7745
(802) 775-5155
Mailing address
215 STRATTON RD, RUTLAND, VT 05701-4621
(802) 775-7745
(802) 775-5155
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
042-0010388
VT
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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