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Organization

RIVER BIRCH OCCUPATIONAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LORIE B WYMAN OTR/L (OCCUPATIONAL THERAPIST)
(207) 468-1293
Entity
Organization

Contact information

Practice address
1236 PORTLAND RD, ARUNDEL, ME 04046-8104
(207) 468-1293
Mailing address
1236 PORTLAND RD, ARUNDEL, ME 04046-8104
(207) 468-1293

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT304
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1366409351
NPI
05
ID 19720000
ME
Enumeration date
05/10/2009
Last updated
05/10/2009
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