Individual
PROF. BEN SIDAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., PT
Contact information
Practice address
577 GREEN LAKE RD, DEDHAM, ME 04429-4523
(207) 843-6137
Mailing address
577 GREEN LAKE RD, DEDHAM, ME 04429-4523
(207) 843-6137
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2634
ME
Other
Enumeration date
08/29/2006
Last updated
08/04/2008
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