| NPI | 1578690848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DONALD BUSH Physician/President 207-783-1328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: ME 36418) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2011-10-07 |