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NPI Code Detail

MEDICARE: SEAL ROCK ASSOCIATES LLC

MEDICARE: SEAL ROCK ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QX0100XOccupational Medicine Clinic/Center36535ME
2261QP2000XPhysical Therapy Clinic/Center36535ME
3235Z00000XSpeech-Language Pathologist36535ME
4314000000XSkilled Nursing Facility36312ME

General Provider Information

NPI Number : 1417939612
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEAL ROCK ASSOCIATES LLC
Provider Business Mailing Address
First Line : 88 HARBOR DRIVE
Second Line :
City : SACO
State : ME
Zip : 04072
Country : US
Telephone Number : 207-283-3646
Fax Number :
Provider Business Practice Location Address
First Line : 88 HARBOR DRIVE
Second Line :
City : SACO
State : ME
Zip : 04072
Country : US
Telephone Number : 207-283-3646
Fax Number :
Authorized Official
Title or Position : CEO
Name : KENNETH BOWDEN
Credential :
Telephone Number : 207-874-2700
Provider Enumeration Date : 11/15/2005
Last Update Date : 09/13/2007

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Directions to “SEAL ROCK ASSOCIATES LLC ” Practice Location

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