Gabrielle Kana Tiezan

NPI #1306485065 in Windham, Maine

Provider Information

NPI Number
1306485065
Entity Type
Individual
Name
Gabrielle Kana Tiezan
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Pharmacist
Enumeration Date
Dec 29, 2019
Last Updated
Dec 29, 2019

Practice Location

Address
741 ROOSEVELT TRL
State
Maine
ZIP Code
04062-5269
Phone
(207) 893-2562

Specialties & Taxonomy Codes

Specialty
Pharmacist

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