Provider Demographics
NPI:1356478911
Name:BARTHOLF, ROBIN J (LIC AC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:J
Last Name:BARTHOLF
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GUADALUPE CLINIC
Mailing Address - Street 2:180 KENNEDY MEM DR - #202
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901
Mailing Address - Country:US
Mailing Address - Phone:207-872-2900
Mailing Address - Fax:
Practice Address - Street 1:GUADALUPE CLINIC
Practice Address - Street 2:180 KENNEDY MEM DR - #202
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901
Practice Address - Country:US
Practice Address - Phone:207-872-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213681171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist