Organization
MAINE FELDENKRAIS & PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J SULLIVAN PT CFP (PRESIDENT)
(207) 725-7578
Entity
Organization
Contact information
Practice address
34 HENNESSEY AVE., BRUNSWICK, ME 04011-0000
(207) 725-7578
(207) 725-7549
Mailing address
34 HENNESSEY AVE., BRUNSWICK, ME 04011-0000
(207) 725-7578
(207) 725-7549
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT741
ME
225100000X
Physical Therapist
PT745
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031460426
TRICARE
—
01
—
039001
ANTHEM
—
01
—
039097
ANTHEM
—
05
—
131970000
—
ME
01
—
174463443
TRICARE
—
01
—
2374315
AETNA
—
01
—
7202133
AETNA
—
Enumeration date
07/13/2006
Last updated
07/30/2013
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