Individual
MRS. ELISSA B. THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
94 WELD STREET, DIXFIELD, ME 04224-0220
(207) 562-8048
(207) 562-7179
Mailing address
PO BOX 220, DIXFIELD, ME 04224-0220
(207) 562-8048
(207) 563-7179
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000129
ME
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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