Manchester Interventional Spine, LLC
NPI #1952671356 in Manchester, Maine
Provider Information
- NPI Number
- 1952671356
- Entity Type
- Organization
- Organization Name
- Manchester Interventional Spine, LLC
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Jan 3, 2012
- Last Updated
- May 22, 2012
Practice Location
- Address
- 27 BOWDOIN ST
- City
- Manchester
- State
- Maine
- ZIP Code
- 04351-3554
- Phone
- (207) 213-4340
Authorized Official
- Name
- DOUGLAS J JORGENSEN, D.O.
- Title
- MEDICAL DIRECTOR
- Phone
- (207) 622-4500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
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