| NPI | 1184648594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P. MCEWAN Gec Care Line Manager 207-623-8411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: MI 6801086877) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |