| NPI | 1194763110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD MERRILL Administrator 207-307-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-07-16 |