| NPI | 1467157784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE LOTHROP Clinical Director 207-212-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |