Organization
VAN DUSEN MEDICALLY SUPERVISED WEIGHT LOSS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN VAN DUSEN FNP (AUTHORIZED OFFICIAL)
(207) 975-1316
Entity
Organization
Contact information
Practice address
445 ASH POINT DR, OWLS HEAD, ME 04854-3601
(207) 975-1316
Mailing address
445 ASH POINT DR, OWLS HEAD, ME 04854-3601
(207) 975-1316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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