Individual
JORDAN SAMUEL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
28 GILMAN PLZ, BANGOR, ME 04401-3561
(207) 990-0162
Mailing address
28 GILMAN PLZ, BANGOR, ME 04401-3561
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3363
ME
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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