Healthcare Provider Details

I. General information

NPI: 1164006649
Provider Name (Legal Business Name): DENISE DUMONT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE DUMONT-BERNIER PT

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 GRISTMILL LN
SCARBOROUGH ME
04074-8283
US

IV. Provider business mailing address

55 SPRING ST
SCARBOROUGH ME
04074-8926
US

V. Phone/Fax

Practice location:
  • Phone: 207-242-3924
  • Fax: 207-242-3924
Mailing address:
  • Phone: 207-242-3924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberPT846
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: