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General NPI Number Information
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NPI Number | 1659379659
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Entity Type | Individual
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Provider Name | MARY ANN WILMARTH PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 10 NOLLET DR
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City | ANDOVER
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State | MA
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Zip | 01810-6312
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Country | US
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Telephone | 978-682-8802
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Fax | 978-682-8813
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Provider Business Mailing Address
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Address Line | 10 NOLLET DR
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City | ANDOVER
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State | MA
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Zip | 01810-6312
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Country | US
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Telephone | 978-682-8802
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Fax | 978-682-8813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5327
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License Number State | MA
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