Organization Name: | MAINELY KIDZ PT |
NPI Number: | 1730327792 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER CORBEIL (PRESIDENT) |
Mailing Address: | 205 Bolt Hill Rd Eliot |
State: | ME US |
Postal Code: | 039031942 |
Phone Number: | 2074395104 |
Fax Number: | 2075718134 |
NPI Enumeration Date: | 01/29/2009 |
NPI Last Update Date: | 01/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | PT1834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |