Provider Demographics
NPI:1700530599
Name:SOLL, GREGORY M (LAC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:M
Last Name:SOLL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-0435
Mailing Address - Country:US
Mailing Address - Phone:802-343-8640
Mailing Address - Fax:
Practice Address - Street 1:167 PEARL ST STE 2
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3068
Practice Address - Country:US
Practice Address - Phone:802-343-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091.0134062171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist