Individual
LISA BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
167 SEBASTICOOK ST, PITTSFIELD, ME 04967-4107
(207) 416-5236
Mailing address
138 MORRILL ST, PITTSFIELD, ME 04967-4708
(207) 487-1114
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA1570
ME
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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