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General NPI Number Information
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NPI Number | 1659497444
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Entity Type | Organization
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Legal Business Name | FAMILY EAR, NOSE & THROAT, LLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 35 WALKER ST STE 200
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City | KITTERY
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State | ME
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Zip | 03904-1727
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Country | US
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Telephone | 207-475-0100
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Fax | 207-351-3524
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Provider Business Mailing Address
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Address Line | 35 WALKER ST STE 200
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City | KITTERY
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State | ME
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Zip | 03904-1727
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Country | US
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Telephone | 207-351-3525
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Fax | 207-351-3524
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LESLIE N RANKIN
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Credential |
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Telephone | 207-475-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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