| NPI | 1922467596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J VANIDESTINE President 207-942-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |