Individual
MARY KROTH-BRUNET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
94 MAIN ST, GORHAM, ME 04038-1340
(207) 839-5860
(207) 839-2499
Mailing address
94 MAIN ST, GORHAM, ME 04038-1340
(207) 839-5860
(207) 839-2499
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1452
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299900099
—
ME
Enumeration date
06/03/2006
Last updated
07/09/2013
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