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General NPI Number Information
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NPI Number | 1619907888
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Entity Type | Organization
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Legal Business Name | HOLISTIC PHYSICAL THERAPY SERVICES INC.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 100 BRICKHILL AVE SUITE 301
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-1999
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Country | US
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Telephone | 207-879-7510
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Fax | 207-879-7511
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Provider Business Mailing Address
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Address Line | 100 BRICKHILL AVE SUITE 301
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-1999
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Country | US
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Telephone | 207-879-7510
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Fax | 207-879-7511
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN M. RAMSEY
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Credential | P.T.
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Telephone | 207-879-7510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT2603
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License Number State | ME
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