Provider Information for 1548573041
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JENNIFER REEDER
Sex: Female
NPI: 1548573041
Last Updated: 2011-09-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1548573041 | ||||||||
| Enumeration Date | 2010-07-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1155 LISBON ST LEWISTON, ME 04240-5025 United States Phone: 207-783-9141 | Fax: | ||||||||
| Primary Practice Address | 32 N HIGH ST BRIDGTON, ME 04009-1125 United States Phone: 207-647-5629 | Fax: | ||||||||
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