| NPI | 1942853635 |
|---|---|
| Former Legal Business Name | OLD SALT PEDIATRIC THERAPY, PLLC |
| Entity Type | Organization |
| Authorized Contact | COURTNEY G ST GERMAIN Owner/Occupational Therapist 207-352-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |