Organization
PENOBSCOT EYE CARE PA
Active
Other names
Penobscot Eye Care INC
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY D. ALLEN (SEC / TRES)
(207) 942-2015
Entity
Organization
Contact information
Practice address
29 DIRIGO DRIVE, BREWER, ME 04412-1600
(207) 942-2015
Mailing address
29 DIRIGO DRIVE, BREWER, ME 04412-1600
(207) 942-2015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119630001
—
ME
Enumeration date
06/10/2006
Last updated
06/15/2020
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