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NPI Code Detail

MEDICARE: MARSHALL CRAGGY

MEDICARE: MARSHALL CRAGGY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMT4113ME

General Provider Information

NPI Number : 1609102946
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHALL CRAGGY
Provider Business Mailing Address
First Line : 116 FREE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3925
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 116 FREE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3925
Country : US
Telephone Number : 207-773-8393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2009
Last Update Date : 10/21/2009

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Directions to “ MARSHALL CRAGGY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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