LOLA LOUISE AMDAHL

PORTLAND, ME
NPI1487291050
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ME  PA2334)
Additional Taxonomies363A00000X Physician Assistant
(Licence: VT  055-0031471)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-12-03
Last Update Date2022-09-12
Business Address
LOLA LOUISE AMDAHL PA-C
1600 CONGRESS ST STE B
PORTLAND, ME 04102-2148
Phone number: 207-774-5222
Mailing Address
LOLA LOUISE AMDAHL PA-C
557 OCEAN ST
SOUTH PORTLAND, ME 04106-6625
Phone number: 603-252-0556