Provider Demographics
NPI:1760444996
Name:FALMOUTH PHYSICAL THERAPY ASSOC
Entity type:Organization
Organization Name:FALMOUTH PHYSICAL THERAPY ASSOC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-781-2543
Mailing Address - Street 1:PO BOX 6073
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-7083
Mailing Address - Country:US
Mailing Address - Phone:207-781-2543
Mailing Address - Fax:207-781-5077
Practice Address - Street 1:361 US ROUTE 1
Practice Address - Street 2:STE 4
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-2543
Practice Address - Fax:207-781-5077
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALMOUTH PHYSICAL THERAPY ASSOC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME118310000Medicaid
MEM754OtherCIGNA
ME001779OtherFEDERAL BC/BS
MAZL6507OtherBC/BS OF MASS
ME1041847OtherAETNA
MAZL6507OtherBC/BS OF MASS