Provider Demographics
NPI:1538831938
Name:MCGEHEE, CONNOR NICHOLAS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:NICHOLAS
Last Name:MCGEHEE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:WALDOBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04572-1367
Mailing Address - Country:US
Mailing Address - Phone:207-832-5544
Mailing Address - Fax:
Practice Address - Street 1:75 WINSLOWS MILLS RD
Practice Address - Street 2:
Practice Address - City:WALDOBORO
Practice Address - State:ME
Practice Address - Zip Code:04572
Practice Address - Country:US
Practice Address - Phone:207-832-5544
Practice Address - Fax:207-832-5507
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPT5972OtherME/MAINE PT LICENSE NUMBER