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1548963556
AVERY THOMAS PELLNAT
PORTLAND, ME
NPI
1548963556
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-27
Last Update Date
2023-03-27
Business Address
-- AVERY THOMAS PELLNAT MD
22 BRAMHALL ST
PORTLAND, ME 04102-3175
Phone number: 207-662-0111
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Mailing Address
-- AVERY THOMAS PELLNAT MD
22 BRAMHALL ST
PORTLAND, ME 04102-3175
Phone number: 207-662-0111
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