Individual
SUSAN JEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
690 MINOT AVE STE 2, AUBURN, ME 04210-3922
(207) 783-3450
Mailing address
77 AUSTIN RD, LEEDS, ME 04263-3311
(207) 524-7151
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT171
LICENSE#
ME
Enumeration date
11/03/2006
Last updated
07/08/2007
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