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1601 Congress St Portland ME 04102-2102 | |
| (207) 780-2900 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies - Customized Equipment |
| Location | 1601 Congress St, Portland, Maine |
| Authorized Official Name and Position | David Kerr (OWNER) |
| Authorized Official Contact | 2077802900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1601 Congress St Portland ME 04102-2102 Ph: (207) 775-0001 | 1601 Congress St Portland ME 04102-2102 Ph: (207) 780-2900 |
| NPI Number | 1518335892 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 01/10/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518335892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DEN2946 (Maine) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | DEN2946 (Maine) | Primary |
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