Organization
SOUTHERN MAINE PEDIATRIC THERAPIES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSANNE L MARTORANO OTR/L (OWNER)
(207) 233-7373
Entity
Organization
Contact information
Practice address
14 MURRAY DRIVE, GORHAM, ME 04038
(207) 233-7373
(888) 731-2721
Mailing address
14 MURRAY DRIVE, GORHAM, ME 04038
(207) 233-7373
(888) 731-2721
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1187
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467595322
INDIVIDUAL NPI
—
Enumeration date
11/26/2012
Last updated
11/26/2012
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