Individual
MR. CARROLL L ACKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, CCS
Contact information
Practice address
74 DOWD RD, BANGOR, ME 04401-6700
(207) 947-6800
(207) 947-6872
Mailing address
74 DOWD RD, BANGOR, ME 04401-6700
(207) 947-6800
(207) 947-6872
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
LC1222
ME
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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