| NPI | 1023342185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN J. SIMONS Registered Agent 207-205-2045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT125) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT933) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2012-03-09 |