| NPI | 1275925117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY F ONIK Owner 207-274-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A-1823-14) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM 1363) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |