Boutaugh, Thomas Joseph

Boutaugh, Thomas Joseph is an individual health care provider with primary practice located at 2402 Route 2 Suite 8, Hermon ME 04401-0665. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Boutaugh, Thomas Joseph can be contacted via phone (207) 659-0857.

Contact Information

Primary practice address
2402 Route 2 Suite 8 Hermon ME 04401-0665
Phone: (207) 659-0857
Fax: (207) 404-2562
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2423 Maine

Profile Details

NPI number 1811955115
LBN Legal business name Boutaugh, Thomas Joseph
Credentials MSPT
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Feb 13th, 2012 - about 14 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 1811955115 NPPES
Maine Other 100546 ANTHEM
Maine MEDICAID 248160000 ANTHEM
Maine Other 7538245 ANTHEM

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