Organization
RD 207, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA GOULD MS, RD (REGISTERED DIETITIAN/ LLC MEMBER)
(207) 460-0550
Entity
Organization
Contact information
Practice address
6 STATE ST STE 607, BANGOR, ME 04401-5140
(207) 460-0550
Mailing address
301 WING RD, HERMON, ME 04401-0418
(207) 460-0550
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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