| NPI | 1235692385 |
|---|---|
| Doing Business As | FORM FUNCTION OSTEOPATHIC MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KRIS S. SORNBERGER Owner 207-307-0816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2019-04-07 |