Suzanne Ruth Martin, PTA

Individual provider Active NPI Physical Therapy Assistant · Thomaston, ME

NPI 1306178264 · NPPES record last updated Feb 3, 2010

Key facts

NPI
1306178264
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PA70000924 (ME)
Practice address
12 Duane Ave
Thomaston, ME 04861-3847
Phone
(207) 542-0406
NPI assigned
Feb 3, 2010
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)
No

State licenses

LicenseStateTypeSpecialty
PA70000924MEMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PA70000924 ME Yes

Addresses

Primary practice location

12 Duane Ave
Thomaston, ME 04861-3847

Mailing address

12 Duane Ave
Thomaston, ME 04861-3847
Phone (207) 542-0406

Other providers in Thomaston, ME

All providers in Thomaston, ME · Physical Therapy Assistant in Maine

Sources for this page

Verify at the official NPI Registry.