Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT2852 | ME |
NPI | 1205495330 |
---|---|
Provider Name | Kate Anderson |
First Address | Biddeford, ME 04005-9422 |
Second Address | Biddeford, ME 04005-9422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2019 |
Last Update Date | 12/06/2019 |