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Individual
MR. THOMAS JOSEPH BOUTAUGH
Active
Individual
MR. THOMAS JOSEPH BOUTAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT022319
PA
225100000X
Physical Therapist
PT2423
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100546
ANTHEM
ME
05
—
248160000
—
ME
01
—
7538245
AETNA
ME
Enumeration date
05/03/2006
Last updated
03/31/2025
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