| NPI | 1952671356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J JORGENSEN Medical Director 207-622-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-05-22 |