Provider Demographics
NPI:1871312322
Name:INTEGRATIVE MEDICINE OF MAINE, LLC
Entity type:Organization
Organization Name:INTEGRATIVE MEDICINE OF MAINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-212-9698
Mailing Address - Street 1:273 LOWER ST
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:ME
Mailing Address - Zip Code:04282-3903
Mailing Address - Country:US
Mailing Address - Phone:207-212-9698
Mailing Address - Fax:
Practice Address - Street 1:871 COURT ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-3903
Practice Address - Country:US
Practice Address - Phone:207-376-4983
Practice Address - Fax:207-376-4983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center