Individual
MISS ANNELISE MARIA DEPAULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
45 WESTERN AVE, SOUTH PORTLAND, ME 04106-2411
(207) 772-2625
Mailing address
40 BRACKETT ST, PORTLAND, ME 04102-3970
(484) 903-7733
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT6309
ME
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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