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Organization

KIM GOODING OCCUPATIONAL THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIM GOODING MS,OTR/L,CLT (OWNER/SOLE PROPRIETOR)
(207) 749-2234
Entity
Organization

Contact information

Practice address
25 DALLAS HILL ROAD, RANGELEY, ME 04970
(207) 864-9220
Mailing address
PO BOX 456, 27 AMBER ROAD, RANGELEY, ME 04970-0456
(207) 864-9220
(207) 512-1031

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
ME1636
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1932377967
NPI
Enumeration date
07/25/2014
Last updated
07/25/2014
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