Provider Demographics
NPI:1427353069
Name:DUFOUR, ROBIN PAGE (PT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:PAGE
Last Name:DUFOUR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LYNN
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:ME
Mailing Address - Zip Code:04351-0552
Mailing Address - Country:US
Mailing Address - Phone:207-557-3493
Mailing Address - Fax:207-626-3334
Practice Address - Street 1:6 ROCKWOOD DR
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:ME
Practice Address - Zip Code:04351
Practice Address - Country:US
Practice Address - Phone:207-626-3333
Practice Address - Fax:207-626-3334
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3103225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist