Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | OT1016 | ME |
Y | 225X00000X | Occupational Therapist | OT1016 | ME |
N | 2251E1200X | Ergonomics | OT1016 | ME |
N | 225XE1200X | Ergonomics | OT1016 | ME |
N | 225XH1200X | Occupational Therapist - Hand | OT1016 | ME |
N | 2251H1300X | Human Factors | OT1016 | ME |
N | 225XH1300X | Human Factors | OT1016 | ME |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT1016 | ME |
NPI | 1881633253 |
---|---|
Provider Name | Mr. Gregory Kirk Molatch |
First Address | Eastbrook, ME 04634-4030 |
Second Address | Ellsworth, ME 04605-1830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 06/02/2008 |