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1891359295
JACOB W SOUCY
PORTLAND, ME
NPI
1891359295
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-05-01
Last Update Date
2019-05-01
Business Address
Mr. JACOB W SOUCY PA-S
716 STEVENS AVE
PORTLAND, ME 04103-2693
Phone number: 297-283-0171
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Mailing Address
Mr. JACOB W SOUCY PA-S
716 STEVENS AVE
PORTLAND, ME 04103-2693
Phone number: 297-283-0171
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