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Individual

JENNIFER KIERAN JOSEPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4892
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-4892

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1080
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
047611
ANTHEM
ME
05
426820099ME
ME
01
P00292631
MEDICARE RAILROAD
ME
Enumeration date
03/06/2007
Last updated
06/28/2019
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