| NPI | 1396319984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE TOMPKINS Owner 207-615-6640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-09-23 |