Organization
NORTHERN MAINE GENERAL
Active
Other names
Northern Aquatics
Organization subpart
No
Provider details
NPI number
Authorized official
REYNOLD RAYMOND (CEO)
(207) 444-5152
Entity
Organization
Contact information
Practice address
37 CARTER STREET, EAGLE LAKE, ME 04739-0310
(207) 444-5152
Mailing address
PO BOX 310, EAGLE LAKE, ME 04739-0310
(207) 444-5152
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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