NPI | 1992194963 |
---|---|
Entity Type | Organization |
Authorized Contact | ROGER A. POITRAS Chief Executive Officer 207-347-2853 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208000000X Pediatrics |
2084P0800X Psychiatry & Neurology, Psychiatry | |
225100000X Physical Therapist | |
Enumeration Date | 2015-01-14 |
Last Update Date | 2025-08-21 |