Individual
PATRICIA A THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSPT
Contact information
Practice address
899 CENTRAL ST, MILLINOCKET, ME 04462-2125
(207) 723-7229
Mailing address
899 CENTRAL ST, MILLINOCKET, ME 04462-2125
(207) 723-7229
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT866
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-0223482
MILLINOCKET REGIONAL HOSPITAL
ME
Enumeration date
03/04/2019
Last updated
03/04/2019
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