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Individual

MR. JOHN STANTON MACINNES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTICIAN CERTIFIED

Contact information

Practice address
885 UNION STREET, SUITE 140, BANGOR, ME 04401-3082
(207) 942-0332
(207) 942-0332
Mailing address
885 UNION STREET, SUITE 140, BANGOR, ME 04401-3082
(207) 942-0332
(207) 942-0332

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
10328
ME

Other

Enumeration date
08/07/2007
Last updated
08/07/2007
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