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NPI Code Detail

MEDICARE: MRS. MARGARET ANNE SMITH OTR LMT

MEDICARE: MRS. MARGARET ANNE SMITH OTR 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
1225700000XMassage TherapistMT2661ME
2225X00000XOccupational TherapistOT307ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OT307OTHERMEME LICENSE

General Provider Information

NPI Number : 1699793794
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARGARET ANNE SMITH OTR LMT
Provider Business Mailing Address
First Line : 1048 UNION ST
Second Line : SUITE 5
City : BANGOR
State : ME
Zip : 04401-0000
Country : US
Telephone Number : 207-945-5247
Fax Number : 207-947-0435
Provider Business Practice Location Address
First Line : 1012 UNION ST
Second Line :
City : BANGOR
State : ME
Zip : 04401-0000
Country : US
Telephone Number : 207-945-5247
Fax Number : 207-947-0435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 12/19/2007

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Directions to “ MRS. MARGARET ANNE SMITH OTR LMT” Practice Location

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