Provider Demographics
NPI:1639786395
Name:CANTIN, KATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CANTIN
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 1:168 HAMMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:ME
Mailing Address - Zip Code:04290-3228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:168 HAMMOND HILL RD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:ME
Practice Address - Zip Code:04290-3228
Practice Address - Country:US
Practice Address - Phone:207-562-7102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist