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JOHN A PELLETIER D.O.

Physicians Neuromusculoskeletal Medicine & OMM

Provider NPI: 1053397760

Provider Information:
 JOHN A PELLETIER D.O.
Gender: M
Not Sole Proprietor

Practice Location:
295 FOREST AVE 2ND FLOOR PORTLAND, ME 04101-2018 US
Tel: 207-772-7417  Fax: 207-772-7465

Business Mailing Address:
295 FOREST AVE 2ND FLOOR PORTLAND, ME 04101-2018 US
Tel: 207-772-7417  Fax: 207-772-7465

NPI Information:
NPI: 1053397760
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y204D00000XPhysicians
Neuromusculoskeletal Medicine & OMM
ME1483

Other Provider Identifiers:

IssuerNumberStateType
208480099ME05



American Medical Association 2012 taxonomy code information

Code: 204D00000X

Type:

Classification:



Definition:



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