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General NPI Number Information
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NPI Number | 1265751515
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Entity Type | Organization
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Legal Business Name | SEACOAST HAND THERAPY
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 12 ATLANTIC PL
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2316
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Country | US
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Telephone | 207-775-4263
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Fax | 207-775-2202
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Provider Business Mailing Address
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Address Line | 12 ATLANTIC PL
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2316
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Country | US
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Telephone | 207-775-4263
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Fax | 207-775-2202
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. JENNIFER A SCHUBERT
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Credential | PT/CHT
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Telephone | 207-775-4263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2014
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License Number State | ME
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