Individual
MS. JESSICA M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
151 MAPLE ST, CORNISH, ME 04020-3103
(207) 625-8494
(207) 625-3880
Mailing address
151 MAPLE ST, CORNISH, ME 04020
(207) 625-4427
(207) 625-3880
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR4052
ME
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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