Organization
SOUTHERN MAINE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA AYRE PT/OWNER (OWNER)
(207) 799-9700
Entity
Organization
Contact information
Practice address
449 COTTAGE RD, SOUTH PORTLAND, ME 04106-4924
(207) 799-9700
(207) 799-9706
Mailing address
449 COTTAGE RD, SOUTH PORTLAND, ME 04106-4924
(207) 799-9700
(207) 799-9706
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225100000X
Physical Therapist
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040910
ANTHEM GROUP NUMBER
ME
01
—
100482300
DEPT OF LABOR WKERS COMP
ME
05
—
130470100
—
ME
01
—
2433023
AETNA GROUP NUMBER
ME
01
—
5182235
CIGNA HEALTH CARE
ME
01
—
DB3088
MEDICARE RAILROAD
ME
01
—
MNT112
HARVARD PILGRIM
ME
Enumeration date
09/22/2006
Last updated
07/21/2022
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