Individual
JILL ANNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
980 FOREST AVE STE 204, PORTLAND, ME 04103-3336
(207) 266-5374
Mailing address
21 QUEBEC ST APT 1, PORTLAND, ME 04101-5301
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT5940
ME
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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