Organization
CORE PHYSICAL THERAPY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA W DOUGLASS PT (PRESIDENT)
(207) 933-6976
Entity
Organization
Contact information
Practice address
392 ROUTE 202, MONMOUTH, ME 04259
(207) 933-6976
(207) 933-6978
Mailing address
PO BOX 221, MONMOUTH, ME 04259-0221
(207) 933-6976
(207) 933-6978
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1419
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041071
ANTHEM
ME
05
—
134850000
—
ME
01
—
2520150
AETNA
ME
01
—
M198161
CIGNA
ME
01
—
MN1386
HARVARD PILGRIM
ME
Enumeration date
04/19/2006
Last updated
10/12/2011
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