Provider Demographics
NPI:1134311970
Name:FREEMAN, THERESA PURINGTON (PT LMT)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:PURINGTON
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PT LMT
Other - Prefix:MISS
Other - First Name:THERESA
Other - Middle Name:KAY
Other - Last Name:PURINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT LMT
Mailing Address - Street 1:7 PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105
Mailing Address - Country:US
Mailing Address - Phone:207-781-6191
Mailing Address - Fax:
Practice Address - Street 1:4 FUNDY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist