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General NPI Number Information
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NPI Number | 1982918157
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Entity Type | Individual
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Provider Name | ELIZABETH MONTEJO DOYLE L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 03/11/2012
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Provider Practice Location Address
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Address Line | 4 FUNDY RD STE 102 AON CENTER FOR INNOVATED BODYWORK
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City | FALMOUTH
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State | ME
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Zip | 04105-1777
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Country | US
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Telephone | 207-781-2370
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Fax |
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Provider Business Mailing Address
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Address Line | 398 W MAIN ST
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City | YARMOUTH
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State | ME
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Zip | 04096-8423
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Country | US
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Telephone | 207-415-4973
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT1900
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License Number State | ME
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