Healthcare Provider Details

I. General information

NPI: 1265741458
Provider Name (Legal Business Name): ISLAND PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 DOGGETT RD
WESTPORT ISLAND ME
04578-3224
US

IV. Provider business mailing address

41 DOGGETT RD
WESTPORT ISLAND ME
04578-3224
US

V. Phone/Fax

Practice location:
  • Phone: 207-882-7581
  • Fax:
Mailing address:
  • Phone: 207-882-7581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAIL M. CADMAN
Title or Position: PRESIDENT
Credential: PT
Phone: 207-882-7581