Provider Demographics
NPI:1528742780
Name:DEMERS, JOSHUA (LMT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:DEMERS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:DEMERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:6 WELLSPRING RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-8418
Mailing Address - Country:US
Mailing Address - Phone:207-494-4656
Mailing Address - Fax:
Practice Address - Street 1:6 WELLSPRING RD STE 206
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-8418
Practice Address - Country:US
Practice Address - Phone:207-494-4656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT7422225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist