| NPI | 1578753836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LATENDRESSE Billing Mgr 207-773-5778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PT2432) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: ME AC200) |
| 225700000X Massage Therapist (Licence: ME MT1458) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2008-09-12 |