| NPI | 1871668947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE GLASS Owner Physiatrist 207-780-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: ME 1249) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: ME 013905) |
| 305S00000X Point of Service (Licence: ME PA-042) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |