Individual
ANGELA LECLERC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
49 SPRING ST, 1ST FLOOR, SCARBOROUGH, ME 04074-8926
(207) 885-0011
(207) 885-5851
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA886
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432508399
—
ME
Enumeration date
03/29/2006
Last updated
09/11/2013
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