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General NPI Number Information
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NPI Number | 1386686616
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Entity Type | Organization
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Legal Business Name | COUNTY PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 118 BENNETT DR SUITE 140
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City | CARIBOU
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State | ME
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Zip | 04736-2052
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Country | US
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Telephone | 207-498-6334
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Fax | 207-493-3247
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Provider Business Mailing Address
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Address Line | 118 BENNETT DR SUITE 140
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City | CARIBOU
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State | ME
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Zip | 04736-2052
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Country | US
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Telephone | 207-498-6334
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Fax | 207-493-3247
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RICHARD J EZZY
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Credential |
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Telephone | 207-498-6334
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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