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PROF. BEN SIDAWAY PH.D., PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1265541973

Individual Registrant:
PROF. BEN  SIDAWAY PH.D., PT
Gender: M
Sole Proprietor

Location and contact information for practice:
577 GREEN LAKE RD  DEDHAM, ME 04429-4523 US
Tel: 207-843-6137  Fax: --

Contact information for business:
577 GREEN LAKE RD  DEDHAM, ME 04429-4523 US
Tel: 207-843-6137  Fax: --

Registration Information:
NPI: 1265541973
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
MEPT2634

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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