Organization
MAST CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE D MAST PT MSED (OWNER/MANAGER/PROVIDER)
(207) 892-5328
Entity
Organization
Contact information
Practice address
1 WESTBROOK CMN, SUITE 2, WESTBROOK, ME 04092-2804
(207) 892-5328
(866) 416-3820
Mailing address
94 RACKLEFF ST, PORTLAND, ME 04103-3054
(207) 892-5328
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
PT677
ME
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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