| NPI | 1841672094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH D BLANK Owner 207-781-8594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: ME MD13305) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |