Individual
ELIZABETH MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 GALLERY BLVD, SCARBOROUGH, ME 04074-6606
(207) 287-0160
Mailing address
10 SANBORN ST, GORHAM, ME 04038-2229
(207) 651-4078
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1936
NH
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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