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NPI Code Detail

MEDICARE: MICHAEL P TARDIF PT

MEDICARE: MICHAEL P TARDIF PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT3181ME

General Provider Information

NPI Number : 1356446629
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL P TARDIF PT
Provider Business Mailing Address
First Line : PO BOX 227
Second Line :
City : HAMPDEN
State : ME
Zip : 04444-0227
Country : US
Telephone Number : 207-974-6479
Fax Number :
Provider Business Practice Location Address
First Line : 11 MAIN RD NORTH
Second Line :
City : HAMPDEN
State : ME
Zip : 04444-1334
Country : US
Telephone Number : 207-974-6479
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 06/16/2011

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