Individual
DANIEL DENNIS TARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
40 CHAPMAN ST, BREWER, ME 04412-1810
(207) 478-6506
(978) 225-2251
Mailing address
40 CHAPMAN STREET, BREWER, ME 04412
(207) 478-6506
(207) 989-9037
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1060
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048932
ANTHEM
ME
01
—
11317104
CAQH
ME
01
—
1393159
AETNA
ME
05
—
260240000
—
ME
01
—
3662706
CIGNA
ME
01
—
510550598
GREAT WEST
ME
01
—
AA34198
HARVARD PILGRAM
ME
01
—
P00286049
RR MEDICARE
ME
Enumeration date
05/01/2007
Last updated
09/13/2017
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