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General NPI Number Information
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NPI Number | 1114350550
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Entity Type | Organization
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Legal Business Name | MEDOMAK VETERINARY SERVICES
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 14 ATLANTIC HWY
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City | WALDOBORO
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State | ME
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Zip | 04572-6014
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Country | US
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Telephone | 207-563-7786
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Fax | 207-563-2235
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Provider Business Mailing Address
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Address Line | 14 ATLANTIC HWY
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City | WALDOBORO
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State | ME
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Zip | 04572-6014
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Country | US
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Telephone | 207-563-7786
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Fax | 207-563-2235
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURIE S. HOWARTH
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Credential | DVM
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Telephone | 207-563-7786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number |
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License Number State |
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