Provider Demographics
NPI:1114214699
Name:ESTES, EMILY ANN (LPTA, LMT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:ESTES
Suffix:
Gender:F
Credentials:LPTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 LUDWIG RD
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04342-3411
Mailing Address - Country:US
Mailing Address - Phone:207-737-2478
Mailing Address - Fax:
Practice Address - Street 1:36 LUDWIG RD
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:ME
Practice Address - Zip Code:04342-3411
Practice Address - Country:US
Practice Address - Phone:207-737-2478
Practice Address - Fax:207-737-2793
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA2640225200000X
MEMT2944225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist