Organization
ELLEN M ANDERSON DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL KIMBALL DPM (OFFICE MANAGER)
(207) 564-2536
Entity
Organization
Contact information
Practice address
839 W MAIN ST, DOVER FOXCROFT, ME 04426-1334
(207) 564-2536
Mailing address
PO BOX 327, DOVER FOXCROFT, ME 04426-0327
(207) 564-2536
(207) 564-8581
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
POD 155
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112960000
—
ME
Enumeration date
02/14/2008
Last updated
03/22/2012
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