| NPI | 1609468347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ANDERS HOLMQUIST Managing Member 207-929-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2021-09-25 |