Provider Demographics
NPI:1336393495
Name:BRIGHT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:BRIGHT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCIOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-380-4280
Mailing Address - Street 1:39 RIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:ME
Mailing Address - Zip Code:04345-5150
Mailing Address - Country:US
Mailing Address - Phone:207-380-4280
Mailing Address - Fax:
Practice Address - Street 1:39 RIPLEY RD
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:ME
Practice Address - Zip Code:04345-5150
Practice Address - Country:US
Practice Address - Phone:207-380-4280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-15
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty