Individual
CHRISTINE MARIE DASTALTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
331 VERANDA STREET, PORTLAND, ME 04103
(207) 874-1125
(207) 874-1127
Mailing address
331 VERANDA STREET, PORTLAND, ME 04103
(207) 874-1125
(207) 874-1127
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3192
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098571
BCBS
ME
Enumeration date
07/25/2007
Last updated
07/25/2007
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