Individual
DEREK WAYNE FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
95 TARYBELU LN, CHINA, ME 04358-4000
(207) 623-8411
Mailing address
95 TARYBELU LN, CHINA, ME 04358-4000
(207) 623-8411
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
TH1597
ME
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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