Organization
OAK GROVE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY PAULES PTA (PHYSICAL THERAPIST ASSISTANT)
(207) 873-0721
Entity
Organization
Contact information
Practice address
27 COOL ST, WATERVILLE, ME 04901-5221
(207) 873-0721
(207) 877-2287
Mailing address
27 COOL ST, WATERVILLE, ME 04901-5221
(207) 873-0721
(207) 877-2287
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PA3557
ME
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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