| NPI | 1699238907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LANDRY Owner 207-241-0401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-06-11 |