Willis, Cheryl

Willis, Cheryl is an individual health care provider with primary practice located at 133 Corporate Dr Suite 2, Bangor ME 04401-4312. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Willis, Cheryl can be contacted via phone (207) 992-9286.

Contact Information

Primary practice address
133 Corporate Dr Suite 2 Bangor ME 04401-4312
Phone: (207) 992-9286
Fax: (207) 992-9287
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PA1383 Maine

Profile Details

NPI number 1609885052
LBN Legal business name Willis, Cheryl
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Jan 21st, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609885052 NPPES
Maine MEDICAID 267590099

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