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1407682446
ALYSSA CROCKETT
SOUTH PORTLAND, ME
NPI
1407682446
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: ME mt6607)
Enumeration Date
2024-09-09
Last Update Date
2024-09-09
Business Address
ALYSSA CROCKETT lmt
118 MAINE MALL RD
SOUTH PORTLAND, ME 04106-2309
Phone number: 207-772-1031
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Mailing Address
ALYSSA CROCKETT lmt
58 ACADEMY ST
AUBURN, ME 04210-5705
Phone number: 207-461-5824
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