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Individual

CASEY MARIE NORTHUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
360 BROADWAY, BANGOR, ME 04401-3900
(207) 907-1000
Mailing address
22 JOHNSON RD, GUILFORD, ME 04443-6213
(207) 343-1757

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PI46330
ME

Other

Enumeration date
08/20/2018
Last updated
08/20/2018
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