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1063453751
VANCE WORMWOOD
PORTLAND, ME
NPI
1063453751
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: ME R019157)
Enumeration Date
2006-06-10
Last Update Date
2014-11-26
Business Address
-- VANCE WORMWOOD CRNA
22 BRAMHALL ST
PORTLAND, ME 04102-3134
Phone number: 207-662-7046
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Mailing Address
-- VANCE WORMWOOD CRNA
22 BRAMHALL ST
PORTLAND, ME 04102-3134
Phone number: 207-662-7046
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