Individual
LINE C. PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
123 ANDOVER RD, WESTBROOK, ME 04092-3848
(207) 761-2200
(207) 761-2108
Mailing address
190 RIVERSIDE ST, UNIT 6B, PORTLAND, ME 04103-1073
(207) 661-2018
(207) 661-2033
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA653
ME
Other
Enumeration date
12/12/2006
Last updated
01/03/2019
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