Provider Demographics
NPI:1821305111
Name:COMBS, PATRICIA A (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:COMBS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BEAVER MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:VT
Mailing Address - Zip Code:05065-6622
Mailing Address - Country:US
Mailing Address - Phone:802-763-7085
Mailing Address - Fax:
Practice Address - Street 1:320 ROUTE 5 S
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-9431
Practice Address - Country:US
Practice Address - Phone:802-779-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091-0000193171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist