LIEVIN UMBA PHUKUTA

PORTLAND, ME
NPI1346864279
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2020-06-06
Last Update Date2021-08-18
Business Address
LIEVIN UMBA PHUKUTA
716 STEVENS AVE
PORTLAND, ME 04103-2656
Phone number: 207-283-0171
Mailing Address
LIEVIN UMBA PHUKUTA
716 STEVENS AVE
PORTLAND, ME 04103-2656
Phone number: