Pine State Low Vision Services LLC

NPI #1750500013 in Cumberland Center, Maine

Provider Information

NPI Number: 1750500013
Entity Type: Organization
Organization Name: Pine State Low Vision Services LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Apr 25, 2007
Last Updated: Apr 14, 2008

Practice Location

Address: 19 OLD COLONY LN
City: Cumberland Center
State: Maine
ZIP Code: 04021-3053
Phone: (207) 329-2497

Authorized Official

Name: SHERRY A MACKINNON, OTR L
Title: OWNER AND PROVIDER
Phone: (207) 329-2497

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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