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General NPI Number Information
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NPI Number | 1174336473
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Entity Type | Individual
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Provider Name | ELIJAH AMES MT
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Gender | Male
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 63 ABBOTT HILL RD
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City | DEXTER
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State | ME
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Zip | 04930-1154
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Country | US
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Telephone | 207-907-2637
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Fax | 207-990-2308
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Provider Business Mailing Address
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Address Line | 63 ABBOTT HILL RD
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City | DEXTER
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State | ME
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Zip | 04930-1154
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Country | US
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Telephone | 207-907-2637
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Fax | 207-990-2308
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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 | MT7581
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License Number State | ME
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