Provider Demographics
NPI:1871809640
Name:ABRAHAM, ROBARD G (PT, DPT, WCC)
Entity type:Individual
Prefix:DR
First Name:ROBARD
Middle Name:G
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:PT, DPT, WCC
Other - Prefix:DR
Other - First Name:ROBARD
Other - Middle Name:G
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT, WCC
Mailing Address - Street 1:18 SPRING ST # 1B
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6817
Mailing Address - Country:US
Mailing Address - Phone:207-338-3955
Mailing Address - Fax:
Practice Address - Street 1:27 CROSS ST
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915
Practice Address - Country:US
Practice Address - Phone:207-338-3955
Practice Address - Fax:207-338-2642
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist