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-- EDWARD VICTOR SMALL Jr. PTA

Individual Provider (NPI-1) Active

Physical Therapy Assistant

Provider Information

NPI Number
1508107665
Provider Type
Individual Provider (NPI-1)
Credentials
PTA
Status
Active

Contact & Location

Address
489 STATE ST, BANGOR, ME, 044016616
Phone
(207) 973-8086

Specialties & Taxonomies

Physical Therapy Assistant Primary License: ME #PA3405

All Addresses

MAILING

297 BIRCH ST

BANGOR, ME, 044014025

(864) 979-8976

LOCATION

489 STATE ST

BANGOR, ME, 044016616

(207) 973-8086