Organization
INNOVATIVE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOREEN HOLMES (PRESIDENT/OWNER)
(207) 737-7000
Entity
Organization
Contact information
Practice address
3 HOMESTEAD WAY, RICHMOND, ME 04357-3728
(207) 737-7000
(207) 737-7028
Mailing address
3 HOMESTEAD WAY, RICHMOND, ME 04357-3728
(207) 737-7000
(207) 737-7028
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061229
ANTHEM
ME
01
—
604283700
US DEPT. OF LABOR
ME
01
—
7872333
AETNA
ME
01
—
AA26682
HARVARD PILGRIM
ME
01
—
C03561645
MARTINS POINT
ME
Enumeration date
08/09/2005
Last updated
01/06/2020
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