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Leif Erickson, Od, LLC

Optometrist in Rutland, VT. Organization (NPI-2).

NPI number1477587939
StatusActive
Last updated in NPPESMar 25, 2009

Details

NPI
1477587939
Entity type
Organization (NPI-2)
Legal business name
Leif Erickson, Od, LLC
Organization subpart
No
Enumeration date
Jul 10, 2006
Last updated
Mar 25, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist0300000275VTYes

Practice location

44 Washington St
Rutland, VT 05701-5031

Phone 802-775-0862 · Fax 802-747-7714

Mailing address

44 Washington St
Rutland, VT 05701-5031

Phone 802-775-0862 · Fax 802-747-7714

Authorized official

Robert Leif Erickson
Optometrist
8027750862

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