Organization
MANNA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KOHL (CFO)
(207) 945-5247
Entity
Organization
Contact information
Practice address
1048 UNION ST STE 5, BANGOR, ME 04401-8601
(207) 945-5247
(207) 992-2154
Mailing address
629 MAIN ST, BANGOR, ME 04401-6848
(207) 990-2870
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
08/22/2020
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