Organization Name: | GUY A DEFEO, DO, LLC |
NPI Number: | 1942630918 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GUY A DEFEO (OWNER) |
Mailing Address: | 170 Federal St Alfred |
State: | ME US |
Postal Code: | 040023130 |
Phone Number: | 2074675932 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2013 |
NPI Last Update Date: | 11/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 1313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |