NPI | 1568979631 |
---|---|
Entity Type | Organization |
Authorized Contact | JILL D MAHONEY Physician/Owner 207-396-1440 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD17055) |
Enumeration Date | 2018-01-10 |
Last Update Date | 2018-01-10 |