Leslie Karen Randolph Anderson, PT
Individual provider Active NPI Physical Therapist · Caribou, ME
NPI 1336286343 · NPPES record last updated Aug 8, 2012
Key facts
- NPI
- 1336286343
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 950 (ME)
- Practice address
- 163 Van Buren Rd
Suite 1
Caribou, ME 04736-3567 - Phone
- (207) 498-1204
- Fax
- (207) 498-1355
- NPI assigned
- Jan 31, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 950 | ME | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 950 | ME | Yes |
Addresses
Primary practice location
163 Van Buren Rd
Suite 1
Caribou, ME 04736-3567
Mailing address
PO Box 262
11 Raymond Joseph Lane
Caribou, ME 04736-2046
Phone (207) 498-1204
Other providers in Caribou, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.