Healthcare Provider Details

I. General information

NPI: 1578687489
Provider Name (Legal Business Name): ADAPTIVE MOVEMENT SERVICES P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 SUMMIT SPRING RD
POLAND SPRING ME
04274-6709
US

IV. Provider business mailing address

295 SUMMIT SPRING RD
POLAND SPRING ME
04274-6709
US

V. Phone/Fax

Practice location:
  • Phone: 207-998-2437
  • Fax: 207-998-3517
Mailing address:
  • Phone: 207-998-2437
  • Fax: 207-998-3517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT166
License Number StateME

VIII. Authorized Official

Name: MS. CHRISTINE BALDWIN
Title or Position: OWNER
Credential: RPT
Phone: 207-998-2437