| NPI | 1396427407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE FOURNIER Practice Administrator 207-786-1917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-09 |