Individual
CODY LEVENSALOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
31 MAPLE ST, DOVER FOXCROFT, ME 04426-1317
(207) 717-0875
Mailing address
31 MAPLE ST, DOVER FOXCROFT, ME 04426-1317
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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