Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT1601 | ME |
NPI | 1003147471 |
---|---|
Provider Name | Mr. Brian Christian Downing |
First Address | Waldoboro, ME 04572-5922 |
Second Address | Waldoboro, ME 04572-5922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2010 |
Last Update Date | 09/02/2010 |