Individual
DEBRA ANN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
263 STATE ST, SUITE 6, BANGOR, ME 04401-5435
(207) 989-7473
Mailing address
263 STATE ST, SUITE 6, BANGOR, ME 04401-5435
(207) 989-7473
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT2872
ME
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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