NPI | 1003098252 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA NORSWORTHY Practice Manager 207-370-3105 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2007-11-29 |
Last Update Date | 2024-07-01 |