Individual
MR. GARTH WARD DANIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
404 STATE ST, STE 400, BANGOR, ME 04401-6623
(207) 942-7630
(207) 942-5686
Mailing address
19 RIDGE RD, BELMONT, ME 04952-3113
(207) 322-6243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2906
ME
Other
Enumeration date
06/14/2005
Last updated
07/08/2007
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