Organization
SCOTT J DAVIDSON
Active
Parent organization
SCOTT J DAVIDSON
Organization subpart
Yes
Provider details
NPI number
Legal business name
SCOTT J DAVIDSON
Authorized official
SCOTT DAVIDSON (OWNER)
(207) 751-5429
Entity
Organization
Contact information
Practice address
9 EVERETT ST, BRUNSWICK, ME 04011-2403
(207) 751-5429
Mailing address
PO BOX 871, BRUNSWICK, ME 04011-0871
(207) 751-5429
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135350000
—
ME
Enumeration date
02/15/2020
Last updated
02/15/2020
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