Most Relevant Information
Provider Data
| NPI Number: | 1003025214 |
| Provider Name: | KELLY ANN HANSCOM PT |
| Entity Type: | Individual |
| Taxonomy Code: | 2251E1200X |
| Specialty: | Physical Therapist |
| License Number: | PT2820 |
Most Important Dates
| Enumeration Date: | 05/22/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
149 SILVER ST
WATERVILLE
ME
049015813
Practice Location Phone/Fax
| Phone: | 2078734638 |
| Fax: | 2078731541 |
Provider Mailing Location
12 COTTLE RD
OAKLAND
ME
049634842
Provider Mailing Phone/Fax
| Phone: | 2074653388 |
| Fax: |