| NPI | 1205038544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA S. BOUDREAU Office Manager 207-784-3564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2011-01-03 |