Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT2449 | ME |
N | 2251E1200X | Ergonomics | PT2449 | ME |
N | 225XE1200X | Ergonomics | PT2449 | ME |
NPI | 1356449995 |
---|---|
Provider Name | Ms. Janet Mary Case |
First Address | Charlotte, ME 04666-6624 |
Second Address | Charlotte, ME 04666-6624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 21/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11364484 | CAQH (01) | ME |
1356449995 | ANTHEM BCBS (01) | ME |
4591160 | ORTHONET & CIGNA- FACILITY ID (01) | ME |
7886837 | AETNA PIN (01) | ME |