| NPI | 1124005590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BREAREY Ophthalmic Manager 207-324-3380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME 013866) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 9375) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2020-08-22 |