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NPI 1104245364

NPI 1104245364 : ELIZABETH ARNTZEN LMT : ELLSWORTH, ME

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General NPI Number Information
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    NPI Number           |    1104245364
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH ARNTZEN LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/15/2014
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    Last Update Date     |    04/15/2014
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Provider Practice Location Address
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    Address Line         |    61 PINE ST. 
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    City                 |    ELLSWORTH
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    State                |    ME
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    Zip                  |    04605
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    Country              |    US
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    Telephone            |    207-266-7753
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    Fax                  |    207-667-4503
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Provider Business Mailing Address
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    Address Line         |    61 PINE ST. 
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    City                 |    ELLSWORTH
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    State                |    ME
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    Zip                  |    04605
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    Country              |    US
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    Telephone            |    207-266-7753
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    Fax                  |    207-667-4503
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MT4493
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    License Number State |    ME
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