Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | DO2555 | ME |
NPI | 1114213667 |
---|---|
Provider Name | Alison Savage Lee |
First Address | South Portland, ME 04106-3266 |
Second Address | Portland, ME 04102-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 11/11/2015 |