Healthcare Provider Details

I. General information

NPI: 1881637114
Provider Name (Legal Business Name): MICHELE G STEVENS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE G CUMMINGS P.T.

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 2ND ST
FARMINGDALE ME
04344
US

IV. Provider business mailing address

416 KNOWLES RD
BELGRADE ME
04917-3941
US

V. Phone/Fax

Practice location:
  • Phone: 207-582-9898
  • Fax: 207-582-9899
Mailing address:
  • Phone: 207-620-2615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1251
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: