Individual
MRS. SANDRA SUE BERUBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
396 COUNTRY CLUB RD, SANFORD, ME 04073-5226
(207) 608-3198
Mailing address
396 COUNTRY CLUB RD, SANFORD, ME 04073-5226
(207) 608-3198
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
ME
246Z00000X
Other Specialist/Technologist
—
ME
261QP2300X
Primary Care Clinic/Center
Primary
—
ME
Other
Enumeration date
10/05/2014
Last updated
10/05/2014
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