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General NPI Number Information
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NPI Number | 1578687489
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Entity Type | Organization
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Legal Business Name | ADAPTIVE MOVEMENT SERVICES P.A.
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Dates
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Enumeration Date | 03/17/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 295 SUMMIT SPRING RD
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City | POLAND SPRING
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State | ME
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Zip | 04274-6709
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Country | US
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Telephone | 207-998-2437
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Fax | 207-998-3517
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Provider Business Mailing Address
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Address Line | 295 SUMMIT SPRING RD
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City | POLAND SPRING
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State | ME
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Zip | 04274-6709
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Country | US
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Telephone | 207-998-2437
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Fax | 207-998-3517
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHRISTINE BALDWIN
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Credential | RPT
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Telephone | 207-998-2437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT166
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License Number State | ME
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