Individual
MARY REAP BOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
280 BRIGHTON AVE, PORTLAND, ME 04102-2345
(207) 749-9885
Mailing address
280 BRIGHTON AVE, PORTLAND, ME 04102-2345
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT5360
ME
Other
Enumeration date
08/13/2014
Last updated
08/13/2014
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