Individual
JILL M AMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
15 LOWELL ST, PORTLAND, ME 04102-2748
(207) 774-8277
(207) 699-5850
Mailing address
21 BARLEY LN, SCARBOROUGH, ME 04074-8442
(207) 415-4709
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT843
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323720099
—
ME
Enumeration date
06/23/2005
Last updated
03/16/2017
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