Gwenevere Jean Cookson, PT
Individual provider Active NPI Physical Therapist · Rockland, ME
NPI 1679972343 · NPPES record last updated Feb 17, 2017
Key facts
- NPI
- 1679972343
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT4252 (ME)
- Practice address
- 91 Camden St
Suite 401
Rockland, ME 04841-2455 - Phone
- (207) 593-6682
- Fax
- (207) 213-1075
- NPI assigned
- Aug 19, 2014
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT4252 | ME | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4252 | ME | Yes |
Addresses
Primary practice location
91 Camden St
Suite 401
Rockland, ME 04841-2455
Mailing address
91 Camden St
Suite 401
Rockland, ME 04841-2455
Phone (207) 593-6682
Other names
- Gwenevere Jean Maddox
Other providers in Rockland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2017. 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.