| NPI | 1609057900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIEN C DAVIS Owner/Provider 207-236-2201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: ME R030681) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: ME R028675) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2013-03-14 |