Organization
PEDIATRIC PHYSICAL THERAPY CONNECTION
Active
Other names
Brenda Mattson
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA MATTSON PT BOCO (OWNER PHYSICAL THERAPIST ORTHOTIST)
(207) 781-5369
Entity
Organization
Contact information
Practice address
170 US ROUTE ONE, SUITE 180, FALMOUTH, ME 04105
(207) 781-5369
(207) 781-5862
Mailing address
PO BOX 66821, FALMOUTH, ME 04105-6821
(207) 781-5369
(207) 781-5862
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
C15212
MD
225100000X
Physical Therapist
PT0512
ME
332BC3200X
Customized Equipment (DME)
C15212
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018251
ANTHEM BCBS
—
01
—
1042321
AETNA
—
01
—
2434074
AETNA DME
—
01
—
37938
HARVARD PILGRIM
—
01
—
M23095
CIGNA
—
01
—
M230950
CIGNA DME
—
Enumeration date
08/09/2006
Last updated
02/21/2008
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