| NPI | 1063851046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN TETZLAFF Owner 207-699-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME NP548701) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2019-05-22 |