Brian J Fortie

NPI 1255626784 - Physician Assistant - 363A00000X

NPI Details
NPI 1255626784
Gender Male
Enumeration Date 06/13/2011
Last Updated 06/13/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
200 KENNEDY MEMORIAL DR
WATERVILLE ME, 04901-4526, US
Phone (207) 861-3019
Fax
Business Location
12 LIBERTY LN UNIT 70
SOUTH PORTLAND ME, 04106-1979, US
Phone (801) 573-6331
Fax
Toxanomy
Taxonomy Code 363A00000X
License State
License Number
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According to our database, Brian J Fortie NPI is 1255626784, taxonomy code is 363A00000X Brian J Fortie physically located at 200 Kennedy Memorial Dr, Waterville ME, 04901-4526. NPI Number Brian J Fortie has the Individual type.

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1255626784 NPI number is provided on an as is basis without warranty of any kind. 1255626784 is maintained by the National Plan & Provider Enumeration System. The contents of Brian J Fortie are for informational purposes only.