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General NPI Number Information
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NPI Number | 1457421943
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Entity Type | Organization
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Legal Business Name | ABSOLUTE PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1365 BROADWAY
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City | BANGOR
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State | ME
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Zip | 04401-2401
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Country | US
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Telephone | 207-942-2233
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Fax | 207-262-1130
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Provider Business Mailing Address
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Address Line | 1365 BROADWAY
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City | BANGOR
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State | ME
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Zip | 04401-2401
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Country | US
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Telephone | 207-942-2233
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Fax | 207-262-1130
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC M. CORMIER
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Credential | PT
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Telephone | 207-942-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT2419
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License Number State | ME
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