| NPI | 1497343461 |
|---|---|
| Other Name | NEW BALANCE SKOWHEGAN @ MARATHON HEALTH |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-06 |