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1629090519
IDA M. GAMMON-WILSON
FARMINGDALE, ME
NPI
1629090519
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: ME ME#MT6)
Enumeration Date
2006-07-23
Last Update Date
2007-07-08
Business Address
-- IDA M. GAMMON-WILSON LMT, CBT
690 MAINE AVE
FARMINGDALE, ME 04344-1539
Phone number: 207-622-4062
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Mailing Address
-- IDA M. GAMMON-WILSON LMT, CBT
PO BOX 502
HALLOWELL, ME 04347-0502
Phone number: 207-622-4062
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