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General NPI Number Information
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NPI Number | 1851623300
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Entity Type | Individual
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Provider Name | TIFFANY MARIE RANSOM PTA
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Gender | Female
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 22 NORTHBROOK DR
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City | FALMOUTH
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State | ME
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Zip | 04105-1318
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Country | US
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Telephone | 207-781-5775
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Fax |
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Provider Business Mailing Address
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Address Line | D6 JUNIPER E
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City | YARMOUTH
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State | ME
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Zip | 04096-1442
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Country | US
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Telephone |
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PA3481
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License Number State | ME
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