Provider Demographics
NPI:1356958581
Name:DRAG, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DRAG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:ME
Mailing Address - Zip Code:04271-0140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:512 PARIS HILL RD
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:ME
Practice Address - Zip Code:04271
Practice Address - Country:US
Practice Address - Phone:207-739-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer