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Individual

MS. ALBERTINE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
105 MECHANIC ST, CAMDEN, ME 04843-1811
(207) 478-5630
Mailing address
39 RANDOLPH DR, BANGOR, ME 04401-2827
(207) 478-5630

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
225200000X
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225200000
PHYSICAL THERAPY ASSISTANT
ME
Enumeration date
02/02/2009
Last updated
10/23/2024
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