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Individual

GLORIA PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
31 WILLOW ST, BATH, ME 04530-2719
(207) 442-8229
Mailing address
31 WILLOW ST, BATH, ME 04530-2719

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0601
VA
ME
Enumeration date
09/30/2019
Last updated
09/30/2019
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