| NPI | 1558456459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA GOUSSE Practice Administrator 207-773-7964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-09-08 |