Individual
KELLY SANTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
6 BENNETT RD, YARMOUTH, ME 04096-6757
(207) 846-4433
Mailing address
PO BOX 798, YARMOUTH, ME 04096-0798
(207) 846-4433
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT2915
ME
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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