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Individual

KISHAN BHAKTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 COLLEGE CIR, BANGOR, ME 04401-2929
(207) 941-7000
Mailing address
682 OHIO ST APT 13, BANGOR, ME 04401-3195
(806) 494-1037

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI45618
ME

Other

Enumeration date
08/15/2018
Last updated
08/15/2018
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