Doctor Name: | JODY S MCKENNA |
NPI Number: | 1215247036 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT1326 |
Business Practice Address: | 117 Bennoch Rd Orono, ME - 044733620 |
Business Phone Number: | 2078664914 |
Business Fax Number: | |
Mailing Address: | 98 Fountain St, BANGOR |
State: | ME |
Postal Code: | 044013848 |
Phone Number: | 2078528390 |
Fax Number: | |
NPI Enumeration Date: | 10/14/2010 |
NPI Last Update Date: | 02/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT1326 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |