| NPI | 1306022884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT COOLIDGE Agent/Representative 376-774-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME46257) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |