NPI 1619015757

Shannon Paul Reck, HSIDMT

Practitioner Other Technician South Portland, ME

Practice location

Address: 259 High Street US Coast Guard Sector Northern New England, South Portland, ME 04106
Phone: (207) 767-0339
Mailing address: 144 Hawthorne Ln, Westbrook, ME 04092-2756

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Maine →

Registry record

NPI: 1619015757
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Feb 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.