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1457560419
TRACY M BENNETT
BANGOR, ME
NPI
1457560419
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ME PA1097)
Enumeration Date
2007-05-22
Last Update Date
2022-02-03
Business Address
Ms. TRACY M BENNETT P.A.-C
360 BROADWAY
BANGOR, ME 04401-3900
Phone number: 207-907-3650
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Mailing Address
Ms. TRACY M BENNETT P.A.-C
C/OST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT PO BOX 7291
LEWISTON, ME 04243-7291
Phone number: 207-777-8560
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