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1346864279
LIEVIN UMBA PHUKUTA
PORTLAND, ME
NPI
1346864279
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-06-06
Last Update Date
2021-08-18
Business Address
LIEVIN UMBA PHUKUTA
716 STEVENS AVE
PORTLAND, ME 04103-2656
Phone number: 207-283-0171
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Mailing Address
LIEVIN UMBA PHUKUTA
716 STEVENS AVE
PORTLAND, ME 04103-2656
Phone number:
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