Provider Demographics
NPI:1659379659
Name:WILMARTH, MARY ANN (PT, DPT)
Entity Type:Individual
Prefix:PROF
First Name:MARY
Middle Name:ANN
Last Name:WILMARTH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10 NOLLET DR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-6312
Mailing Address - Country:US
Mailing Address - Phone:978-682-8802
Mailing Address - Fax:978-682-8813
Practice Address - Street 1:10 NOLLET DR
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-6312
Practice Address - Country:US
Practice Address - Phone:978-682-8802
Practice Address - Fax:978-682-8813
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA53272251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic