| NPI | 1992700132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ANNE BROCHU Authorized Official 207-783-9653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: ME 36163) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2018-12-10 |