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Organization
WIGGLE WORMS PEDIATRIC PHYSICAL THERAPY, LLC
Active
Organization
WIGGLE WORMS PEDIATRIC PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN M BASTEK (BILLING SPECIALIST)
(207) 351-3078
Entity
Organization
Contact information
Practice address
764 US ROUTE 1, UNIT 4, YORK, ME 03909-5883
(207) 351-3083
(207) 351-3083
Mailing address
764 US ROUTE 1, UNIT 4, YORK, ME 03909-5883
(207) 351-3083
(207) 351-3083
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2587
ME
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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