Provider Demographics
NPI:1669449286
Name:RAVIS, ALISON JUNE (PHYSICIAN ASSSISTANT)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:JUNE
Last Name:RAVIS
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Gender:F
Credentials:PHYSICIAN ASSSISTANT
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Mailing Address - Street 1:70 LINCOLN ST
Mailing Address - Street 2:MILL NO. 6
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7792
Mailing Address - Country:US
Mailing Address - Phone:207-795-7540
Mailing Address - Fax:207-795-7528
Practice Address - Street 1:70 LINCOLN ST
Practice Address - Street 2:MILL NO. 6
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7792
Practice Address - Country:US
Practice Address - Phone:207-795-7540
Practice Address - Fax:207-795-7528
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-10-04
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Provider Licenses
StateLicense IDTaxonomies
MEPA001088363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant