Organization
WILDWORKS THERAPY, PLLC
Active
Other names
Old Salt Pediatric Therapy, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY G ST GERMAIN OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(207) 352-4000
Entity
Organization
Contact information
Practice address
123 MT HOPE AVE, BANGOR, ME 04401
(207) 352-4000
(207) 808-7259
Mailing address
22 PARKWAY S, PO BOX 3461, BREWER, ME 04412
(207) 352-4000
(207) 808-7259
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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