Individual
ANDREW J. TOOTHAKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
392 MAIN ST, WATERBORO, ME 04087-3057
(207) 247-3216
(207) 247-3217
Mailing address
PO BOX 456, WATERBORO, ME 04087-0456
(207) 247-3216
(207) 247-3217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1974
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061160
ANTHEM
ME
Enumeration date
06/25/2006
Last updated
07/08/2007
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