Provider Demographics
NPI:1346367349
Name:DURHAM, ELIZABETH V (PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:V
Last Name:DURHAM
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 1:1 PARKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6076
Mailing Address - Country:US
Mailing Address - Phone:207-323-1021
Mailing Address - Fax:
Practice Address - Street 1:1 PARKSIDE LN
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6076
Practice Address - Country:US
Practice Address - Phone:207-323-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist