MARY DESALLE

SACO, ME
NPI1427034396
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: ME  AP081312)
Additional Taxonomies363LG0600X Nurse Practitioner, Gerontology
(Licence: ME  R026628)
Enumeration Date2005-12-21
Last Update Date2013-02-05
Business Address
-- MARY DESALLE GNP
655 MAIN ST
SACO, ME 04072-1543
Phone number: 207-602-3571
Mailing Address
-- MARY DESALLE GNP
PO BOX 284
BRATTLEBORO, VT 05302-0284
Phone number: 207-784-2554