Individual
JOAN DELUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 UNION ST, BANGOR, ME 04401-3125
(207) 942-7336
Mailing address
750 UNION ST, BANGOR, ME 04401-3125
(207) 942-7336
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA3959
ME
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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