Provider Demographics
NPI:1386126340
Name:MUSINSKI, KATELYN CYR (DPT)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:CYR
Last Name:MUSINSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 CANAAN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-2026
Mailing Address - Country:US
Mailing Address - Phone:207-217-4802
Mailing Address - Fax:
Practice Address - Street 1:37 POND ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4641
Practice Address - Country:US
Practice Address - Phone:207-217-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist