Individual
KELSEY PENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
566 UNION ST, BANGOR, ME 04401-3752
(207) 992-6249
Mailing address
173 PINE ST APT 4, BANGOR, ME 04401-5257
(207) 992-6249
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/19/2018
Last updated
08/19/2018
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