Provider Demographics
NPI:1356449995
Name:CASE, JANET MARY (RPT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARY
Last Name:CASE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 CHARLOTTE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:ME
Mailing Address - Zip Code:04666-6624
Mailing Address - Country:US
Mailing Address - Phone:207-454-4105
Mailing Address - Fax:207-370-6684
Practice Address - Street 1:64 CHARLOTTE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:ME
Practice Address - Zip Code:04666-6624
Practice Address - Country:US
Practice Address - Phone:207-454-4105
Practice Address - Fax:207-370-6684
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2449225100000X, 2251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME11364484OtherCAQH
ME1356449995OtherANTHEM BCBS
ME7886837OtherAETNA PIN
ME4591160OtherORTHONET & CIGNA- FACILITY ID
ME4591160OtherORTHONET & CIGNA- FACILITY ID