Individual
MASHO HAGOS GEBREMIKAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 DANFORTH ST, PORTLAND, ME 04102-3723
(207) 423-4002
Mailing address
225 DANFORTH ST, PORTLAND, ME 04102-3723
(207) 423-4002
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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