Amy St. Peter, PT
Individual provider Active NPI Physical Therapist · Old Town, ME
NPI 1497414890 · NPPES record last updated Dec 13, 2021
Key facts
- NPI
- 1497414890
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT1745 (ME)
- Practice address
- 601 Stillwater Ave
Old Town, ME 04468-2215 - Phone
- (207) 817-0214
- NPI assigned
- Dec 13, 2021
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1745 | ME | Yes |
Addresses
Primary practice location
601 Stillwater Ave
Old Town, ME 04468-2215
Mailing address
79 Poplar St
Bangor, ME 04401-3416
Phone (207) 478-4458
Other names
- Amy Waterman
Other providers in Old Town, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2021. 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.