Provider Demographics
NPI:1639702962
Name:ST. HILAIRE, ROBERT WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:ST. HILAIRE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 HEBRON RD
Mailing Address - Street 2:
Mailing Address - City:BUCKFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04220-4135
Mailing Address - Country:US
Mailing Address - Phone:207-513-7115
Mailing Address - Fax:207-966-0009
Practice Address - Street 1:143 HEBRON RD
Practice Address - Street 2:
Practice Address - City:BUCKFIELD
Practice Address - State:ME
Practice Address - Zip Code:04220-4135
Practice Address - Country:US
Practice Address - Phone:207-513-7115
Practice Address - Fax:207-966-0009
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME5522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist