EDWARD VICTOR SMALL

BANGOR, ME
NPI1508107665
Other NameTED SMALL
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ME  PA3405)
Enumeration Date2013-03-13
Last Update Date2013-03-13
Business Address
-- EDWARD VICTOR SMALL PTA
489 STATE ST
BANGOR, ME 04401-6616
Phone number: 207-973-8086
Mailing Address
-- EDWARD VICTOR SMALL PTA
297 BIRCH ST
BANGOR, ME 04401-4025
Phone number: 864-979-8976
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