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General NPI Number Information
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NPI Number | 1114547122
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Entity Type | Individual
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Provider Name | MARIANNA R DIMAGGIO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 895 PORTLAND RD
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City | SACO
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State | ME
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Zip | 04072-9673
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Country | US
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Telephone | 207-439-5104
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Fax |
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Provider Business Mailing Address
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Address Line | 15 RODERICK AVE
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City | BEVERLY
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State | MA
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Zip | 01915-4062
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Country | US
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Telephone | 978-578-4292
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Fax |
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 21570
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 31182
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 9947
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT5405
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License Number State | ME
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