Individual
JARRED ODOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
716 STEVENS AVE, PORTLAND, ME 04103-2693
(207) 221-4516
Mailing address
19 BAYVIEW DRIVE, ELIOT, ME 03903
(207) 608-1901
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
086213-23
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/30/2019
Last updated
10/05/2021
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