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1881652642
LISA C PRENTISS
PORTLAND, ME
NPI
1881652642
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ME PA430)
Enumeration Date
2006-05-02
Last Update Date
2011-06-03
Business Address
-- LISA C PRENTISS PA
22 BRAMHALL ST PAVILION 1203
PORTLAND, ME 04102-7133
Phone number: 207-662-4618
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Mailing Address
-- LISA C PRENTISS PA
301C US ROUTE ONE
SCARBOROUGH, ME 04074-9701
Phone number: 207-396-8600
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