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1164903647
KIRK MAURICE FONGEMIE
PORTLAND, ME
NPI
1164903647
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: ME SP2539)
Enumeration Date
2018-08-23
Last Update Date
2018-08-23
Business Address
KIRK MAURICE FONGEMIE
1133 WASHINGTON AVE
PORTLAND, ME 04103-3629
Phone number: 207-797-0600
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Mailing Address
KIRK MAURICE FONGEMIE
1133 WASHINGTON AVE
PORTLAND, ME 04103-3629
Phone number: 207-797-0600
Copy
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