Provider Demographics
NPI:1982918157
Name:DOYLE, ELIZABETH MONTEJO (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MONTEJO
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:INDAY
Other - Middle Name:ELIZABETH
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:398 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-8423
Mailing Address - Country:US
Mailing Address - Phone:207-415-4973
Mailing Address - Fax:
Practice Address - Street 1:4 FUNDY RD STE 102
Practice Address - Street 2:AON CENTER FOR INNOVATED BODYWORK
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1777
Practice Address - Country:US
Practice Address - Phone:207-781-2370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT1900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist