KELLY J FIACK

BANGOR, ME
NPI1669812111
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ME  RNA133018)
Enumeration Date2013-06-28
Last Update Date2013-06-28
Business Address
-- KELLY J FIACK CRNA
489 STATE ST
BANGOR, ME 04401-6616
Phone number: 207-992-4032
Mailing Address
-- KELLY J FIACK CRNA
141 N MAIN ST STE 205
BREWER, ME 04412-2055
Phone number: 207-992-4032
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