Provider Demographics
NPI:1992972244
Name:PLUMMER, AMY J (ABOC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CENTER ST STE 204
Mailing Address - Street 2:AUBURN
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6000
Mailing Address - Country:US
Mailing Address - Phone:207-783-4226
Mailing Address - Fax:207-514-0677
Practice Address - Street 1:120 CENTER ST
Practice Address - Street 2:STE 204
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6000
Practice Address - Country:US
Practice Address - Phone:207-783-4226
Practice Address - Fax:207-514-0677
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician