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NPI Code Detail

MEDICARE: GRAY PHYSICAL THERAPY CENTER, PA

MEDICARE: GRAY PHYSICAL THERAPY CENTER, PA
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 Therapist

General Provider Information

NPI Number : 1861449811
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRAY PHYSICAL THERAPY CENTER, PA
Provider Business Mailing Address
First Line : PO BOX 1047
Second Line :
City : GRAY
State : ME
Zip : 04039-1047
Country : US
Telephone Number : 207-657-5600
Fax Number :
Provider Business Practice Location Address
First Line : 6 TURNPIKE ACRES RD
Second Line : STE 2
City : GRAY
State : ME
Zip : 04039-9432
Country : US
Telephone Number : 207-657-5600
Fax Number : 207-657-5620
Authorized Official
Title or Position : PRESIDENT
Name : LEO R CREDIT JR.
Credential : PT
Telephone Number : 207-657-5600
Provider Enumeration Date : 05/27/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1477509115 — LEO R CREDIT JR. PT
Practice Location Address:
6 TURNPIKE ACRES RD
GRAY, ME
04039-9432
Practice Phone: 207-657-5600
Practice Fax: 207-657-5620
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1467650457 — PATRICIA ARLENE KITTREDGE FNP
Practice Location Address:
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Practice Location Address:
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Directions to “GRAY PHYSICAL THERAPY CENTER, PA ” Practice Location

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