MEDICARE: RYAN F PROSSER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	DL436	ME

General Provider Information

NPI Number	:	1427696483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN F PROSSER

Provider Business Mailing Address
First Line	:	8 GREENACRE RD
Second Line	:
City	:	OLD ORCHARD BEACH
State	:	ME
Zip	:	04064-1512
Country	:	US
Telephone Number	:	207-281-2626
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 TURNER ST STE 3
Second Line	:
City	:	AUBURN
State	:	ME
Zip	:	04210-5093
Country	:	US
Telephone Number	:	207-784-0333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2019
Last Update Date	:	12/20/2019

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Directions to “ RYAN F PROSSER ” Practice Location

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