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NPI Code Detail

MEDICARE: MR. DANA PAUL TARDIF P.T. ; LMT

MEDICARE:  MR. DANA PAUL TARDIF  P.T. ; LMT
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 TherapistPT532ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396775383
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANA PAUL TARDIF P.T. ; LMT
Provider Business Mailing Address
First Line : PO BOX 227
Second Line : 11 MAIN ROAD NORTH
City : HAMPDEN
State : ME
Zip : 04444-0227
Country : US
Telephone Number : 207-862-3906
Fax Number : 207-862-2892
Provider Business Practice Location Address
First Line : 11 MAIN ROAD NORTH
Second Line :
City : HAMPDEN
State : ME
Zip : 04444-0227
Country : US
Telephone Number : 207-862-3906
Fax Number : 207-862-2892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 10/25/2018

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Directions to “ MR. DANA PAUL TARDIF P.T. ; LMT” Practice Location

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