Individual
MS. SUSIE A BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CITY CTR, THE BAY CLUB, PORTLAND, ME 04101-6420
(207) 699-2622
Mailing address
83 CARLETON ST, APT. 1, PORTLAND, ME 04102
(207) 699-2622
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT3590
ME
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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