Joanne R Blanchard, PT

Individual provider Active NPI Physical Therapist · Scarborough, ME

NPI 1164536462 · NPPES record last updated Apr 12, 2017

Key facts

NPI
1164536462
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT270 (ME)
Practice address
25 Plaza Dr.
Unit 6
Scarborough, ME 04074
Phone
(207) 289-1010
Fax
(207) 289-1011
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT270MEMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT270 ME Yes

Addresses

Primary practice location

25 Plaza Dr.
Unit 6
Scarborough, ME 04074

Mailing address

25 Plaza Dr.
Unit 6
Scarborough, ME 04074
Phone (207) 289-1010

Other identifiers

IdentifierTypeStateIssuer
11223452OtherMECAQH #

Other providers in Scarborough, ME

All providers in Scarborough, ME · Physical Therapist in Maine

Sources for this page

Verify at the official NPI Registry.