Basic Information
| Provider Information | |||||||||
| NPI: | 1881716892 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTIN | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 YOUNGTOWN RD | ||||||||
| Address2: | |||||||||
| City: | LINCOLNVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048495437 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 105 MECHANIC ST | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048431811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072364197 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT2884 | ME | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.