Individual
LISA MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
295 FOREST AVE, PORTLAND, ME 04101-2018
(207) 885-2098
Mailing address
272 LUDLOW ST, PORTLAND, ME 04102-1808
(207) 400-7218
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR4258
ME
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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