Provider Demographics
NPI:1164765202
Name:HARDY, JEAN (LMT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BACK BELMONT RD
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-7710
Mailing Address - Country:US
Mailing Address - Phone:207-338-5850
Mailing Address - Fax:
Practice Address - Street 1:326 BELMONT AVE
Practice Address - Street 2:ROBERTSON CHIROPRACTIC WELLNESS CENTER
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-7710
Practice Address - Country:US
Practice Address - Phone:207-338-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3821172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist