Provider Demographics
NPI:1154680577
Name:HAY, PENNY JEAN (PT)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:JEAN
Last Name:HAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 WARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:ME
Mailing Address - Zip Code:04950-4020
Mailing Address - Country:US
Mailing Address - Phone:207-696-5825
Mailing Address - Fax:
Practice Address - Street 1:27 COOL ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5221
Practice Address - Country:US
Practice Address - Phone:207-873-0721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist