Healthcare Provider Details

I. General information

NPI: 1457372567
Provider Name (Legal Business Name): SARAH ANN MONKS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 PORTLAND ST
SOUTH BERWICK ME
03908-1203
US

IV. Provider business mailing address

15 HOSPITAL DR SUITE # 106
YORK ME
03909-1011
US

V. Phone/Fax

Practice location:
  • Phone: 207-384-7260
  • Fax: 207-384-7295
Mailing address:
  • Phone: 207-384-7260
  • Fax: 207-384-7295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT3030
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: