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NPI Code Detail

MEDICARE: PROF. MARY ANN WILMARTH PT, DPT

MEDICARE: PROF. MARY ANN WILMARTH PT, DPT
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
12251X0800XOrthopedic Physical Therapist5327MA

General Provider Information

NPI Number : 1659379659
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. MARY ANN WILMARTH PT, DPT
Provider Business Mailing Address
First Line : 10 NOLLET DR
Second Line :
City : ANDOVER
State : MA
Zip : 01810-6312
Country : US
Telephone Number : 978-682-8802
Fax Number : 978-682-8813
Provider Business Practice Location Address
First Line : 10 NOLLET DR
Second Line :
City : ANDOVER
State : MA
Zip : 01810-6312
Country : US
Telephone Number : 978-682-8802
Fax Number : 978-682-8813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 08/17/2010

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Directions to “ PROF. MARY ANN WILMARTH PT, DPT” Practice Location

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