Individual
MR. SHANNON PAUL RECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HS, IDMT
Contact information
Practice address
259 HIGH STREET, US COAST GUARD SECTOR NORTHERN NEW ENGLAND, SOUTH PORTLAND, ME 04106
(207) 767-0339
Mailing address
144 HAWTHORNE LN, WESTBROOK, ME 04092-2756
(207) 318-2145
(207) 741-5470
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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