Individual
AUDREY WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
295 FOREST AVE, PORTLAND, ME 04101-2018
(207) 885-2008
Mailing address
295 FOREST AVE, PORTLAND, ME 04101-2018
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR6067
ME
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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