Organization
SOUTHERN MAINE PHYSICAL THERAPY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONI BLANCHARD (BILLING SPECIALIST)
(207) 854-1239
Entity
Organization
Contact information
Practice address
449 COTTAGE RD, SOUTH PORTLAND, ME 04106-4924
(207) 799-9700
(207) 799-9706
Mailing address
PO BOX 310, WESTBROOK, ME 04098-0310
(207) 854-1239
(207) 854-1230
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040910
ANTHEM BCBS
ME
01
—
2433023
AETNA
ME
01
—
MNT112
HARVARD PILGRIM
ME
Enumeration date
05/11/2007
Last updated
07/21/2022
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