Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1144490921 |
---|---|
Provider Name | Ms. Donna M Rossignol-Roy |
First Address | Fort Kent, ME 04743-1230 |
Second Address | Fort Kent, ME 04743-1230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2008 |
Last Update Date | 07/03/2008 |