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Organization

MANCHESTER INTERVENTIONAL SPINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS J JORGENSEN D.O. (MEDICAL DIRECTOR)
(207) 622-4500
Entity
Organization

Contact information

Practice address
27 BOWDOIN ST, MANCHESTER, ME 04351-3554
(207) 213-4340
Mailing address
27 BOWDOIN ST, MANCHESTER, ME 04351-3554

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
01/03/2012
Last updated
05/22/2012
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