| NPI | 1205367869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CHARLES TARQUINIO Owner 207-590-6945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: GA 72932) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |