Organization
MEDICAL LASER SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY HAGAR (PRACTDICE MANGER)
(207) 761-0177
Entity
Organization
Contact information
Practice address
1375 CONGRESS ST, PORTLAND, ME 04102-2118
(207) 761-0177
Mailing address
1375 CONGRESS ST, PORTLAND, ME 04102-2118
(207) 761-0177
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WE DO NOT PARTICIPAT
WE DO NOT PARTICIPATE
ME
Enumeration date
08/24/2006
Last updated
08/22/2020
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