Provider Demographics
NPI:1154948354
Name:PELKEY, HILLARY LOUISE (PTA)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:LOUISE
Last Name:PELKEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 MATTAMISCONTIS RD
Mailing Address - Street 2:
Mailing Address - City:MATTAMISCONTIS TWP
Mailing Address - State:ME
Mailing Address - Zip Code:04457-5010
Mailing Address - Country:US
Mailing Address - Phone:207-403-3777
Mailing Address - Fax:
Practice Address - Street 1:19 GENERAL MOORE WAY
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1860
Practice Address - Country:US
Practice Address - Phone:207-667-9336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA4529225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant