Provider Demographics
NPI:1811069040
Name:BALENTINE, CATHERINE DENISE (PT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DENISE
Last Name:BALENTINE
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 1:164 YORK WOODS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-2168
Mailing Address - Country:US
Mailing Address - Phone:603-812-6112
Mailing Address - Fax:
Practice Address - Street 1:15 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1011
Practice Address - Country:US
Practice Address - Phone:207-363-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT36572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic