| NPI | 1649810540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L CARR President 207-332-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |