| NPI | 1467051185 |
|---|---|
| Doing Business As | WILDFIRE WEIGHT LOSS |
| Entity Type | Organization |
| Authorized Contact | AUTEUM LAKE Fnp 207-951-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2022-11-28 |