Individual
REBECCA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 522-0337
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA1336
ME
Other
Enumeration date
05/25/2012
Last updated
07/24/2012
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