Individual
GABRIELLE KANA TIEZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
741 ROOSEVELT TRL, WINDHAM, ME 04062-5269
(207) 893-2562
Mailing address
741 ROOSEVELT TRL, WINDHAM, ME 04062-5269
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR69543
ME
Other
Enumeration date
12/29/2019
Last updated
12/29/2019
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