| NPI | 1992194963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM G FERENTZ Chief Financial Officer 207-828-0361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 225100000X Physical Therapist | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2021-07-15 |