Provider Demographics
NPI:1053386854
Name:PROCTOR, KAREN R (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Suffix:
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Mailing Address - Street 1:68 LEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1812
Mailing Address - Country:US
Mailing Address - Phone:207-872-0138
Mailing Address - Fax:
Practice Address - Street 1:43 BAXTER BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-1823
Practice Address - Country:US
Practice Address - Phone:207-874-7992
Practice Address - Fax:207-774-9156
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPT871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist