Individual
MARY KATHRYN FREY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
94 MAIN ST, GORHAM, ME 04038-1340
(207) 839-5860
(207) 839-2499
Mailing address
387 NICOLIN RD, ELLSWORTH, ME 04605-3113
(774) 200-5090
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT016016
GA
Other
Enumeration date
07/18/2022
Last updated
07/27/2023
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