Individual
JENNIFER IVY MCNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
300 MAIN ST, WESTBROOK, ME 04092-4715
(207) 939-7425
(207) 854-2526
Mailing address
300 MAIN ST, WESTBROOK, ME 04092-4715
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT1830
ME
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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