1346858206 NPI number — GAME PLAN PHYSICAL THERAPY, INC.

Table of content: MELANIE HONEYWELL MS, RD, CDE (NPI 1053844894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346858206 NPI number — GAME PLAN PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GAME PLAN PHYSICAL THERAPY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346858206
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 WEYMOUTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRUNSWICK
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04011-2314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-512-6536
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
49 TOPSHAM FAIR MALL RD STE 25
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPSHAM
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04086-1735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-512-6536
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2020

Additional Information

Authorized Official

Authorized Official Last Name:
NOONAN
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO/PHYSICAL THERAPIST
Authorized Official Telephone Number:
617-512-6536

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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