Wiggle Worms Pediatric Physical Therapy, LLC

NPI #1063962116 in York, Maine

Provider Information

NPI Number: 1063962116
Entity Type: Organization
Organization Name: Wiggle Worms Pediatric Physical Therapy, LLC
Primary Specialty: Speech-Language Pathologist
Enumeration Date: Oct 12, 2016
Last Updated: Oct 12, 2016

Practice Location

Address: 764 US ROUTE 1
Address 2: UNIT 4
City: York
State: Maine
ZIP Code: 03909-5883
Phone: (207) 351-3083

Authorized Official

Name: JOAN M BASTEK
Title: BILLING SPECIALIST
Phone: (207) 351-3078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Speech-Language Pathologist	235Z00000X	Primary

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