Individual
MRS. LEAH K ST. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 FISHER RD, BERLIN, VT 05602
(802) 225-1743
Mailing address
130 FISHER RD, BERLIN, VT 05602
(802) 225-1743
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0031718
VT
363AS0400X
Surgical Physician Assistant
PA00637
RI
Other
Enumeration date
04/04/2012
Last updated
01/22/2024
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