| NPI | 1548306723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI DOW Office Manager 207-947-6739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: ME 007119) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |