Individual
JONATHAN W COGGESHALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
27 MILL ST, WALDOBORO, ME 04572-6013
(207) 832-5291
Mailing address
27 MILL ST, WALDOBORO, ME 04572-6013
(207) 832-5291
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-459
ME
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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