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Individual

AMELIA WHALEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
2042 SPRUCE ST, HERMON, ME 04401-0247
(207) 316-3417
(207) 605-0260
Mailing address
2042 SPRUCE ST, HERMON, ME 04401-0247
(207) 316-3417
(207) 605-0260

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4702
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT4702
STATE LICENSE
ME
Enumeration date
08/08/2016
Last updated
07/18/2022
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