KEITH ELLSMORE

SOUTH PORTLAND, ME
NPI1912038001
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: ME  PT1881)
Enumeration Date2007-03-08
Last Update Date2007-07-08
Business Address
-- KEITH ELLSMORE P.T.
105 MAIN ST
SOUTH PORTLAND, ME 04106-2621
Phone number: 207-741-2624
Mailing Address
-- KEITH ELLSMORE P.T.
23 SANBORN ST
GORHAM, ME 04038-2230
Phone number: 207-449-4160