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1497064695
MELISSA LOUSIE JACKSON
SCARBOROUGH, ME
NPI
1497064695
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
204C00000X Neuromusculoskeletal Medicine, Sports Medicine
(Licence: ME MT3643)
Enumeration Date
2010-10-05
Last Update Date
2010-10-05
Business Address
-- MELISSA LOUSIE JACKSON
4 VICTORY LN
SCARBOROUGH, ME 04074-8486
Phone number: 207-939-7627
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Mailing Address
-- MELISSA LOUSIE JACKSON
4 VICTORY LN
SCARBOROUGH, ME 04074-8486
Phone number: 207-939-7627
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