Individual
MR. RICHARD ALLAN GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
363 FERN ST, BANGOR, ME 04401-4060
(207) 944-1848
Mailing address
PO BOX 217, BANGOR, ME 04402-0217
(207) 944-1848
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
432708200
STATE OF MAINE PROVIDER NUMBER
ME
Enumeration date
12/11/2009
Last updated
12/11/2009
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