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Contact Information

WILDWOOD MEDICINE
83 INDIA ST
PORTLAND, ME04101-4210
 Phone: 207-347-7132
 Fax: 207-839-2197
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for WILDWOOD MEDICINE · (Female)

NPI # 1063671121
Status Active
Credentials
Entity Individual
Enumeration date 06/04/2008
Last updated 09/08/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • ME License # AC281
  • ME License # AC308
  • ME License # PT3116
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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