| NPI | 1649280637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA MATTSON Owner Physical Therapist Orthotist 207-781-5369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: MD C15212) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT0512) |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: ME C15212) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2008-02-21 |