Individual
KATHLEEN DONOVAN RYAN
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) 662-0111
Mailing address
1 DEERING ST APT 5, PORTLAND, ME 04101-2339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAN1690
ME
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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