Individual
JILL BEAUCAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
690 MINOT AVE, SUITE TWO, AUBURN, ME 04210-3922
(207) 783-3450
Mailing address
82 PULSIFER RD, POLAND, ME 04274-6515
(207) 576-9863
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1832
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT1832
LICENSE
ME
Enumeration date
08/21/2006
Last updated
07/08/2007
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