| NPI | 1831186972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERTRUDE TIMBERLAKE Patient Accts/Billing Coordinator 207-783-0591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |