Individual
ERIC LYLE GOSSELIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T., ATC, CSCS
Contact information
Practice address
82 VESPER ST, APT 1, PORTLAND, ME 04101-4493
(407) 791-3723
Mailing address
275 BATH RD, SUITE 2, BRUNSWICK, ME 04011-2671
(407) 791-3723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
17755
MA
225100000X
Physical Therapist
PT 22300
FL
2251X0800X
Orthopedic Physical Therapist
Primary
PT3292
ME
2255A2300X
Athletic Trainer
AL 1851
FL
Other
Enumeration date
05/08/2007
Last updated
02/24/2010
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