Individual
NANCY CHARLEBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
100 FORE ST, 2ND FLOOR, PORTLAND, ME 04101
(207) 773-5778
(207) 773-5773
Mailing address
100 FORE ST, 2ND FLOOR, PORTLAND, ME 04101
(207) 773-5778
(207) 773-5773
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2432
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047653
ANTHEM
—
05
—
415760099
—
ME
01
—
432865500
MAINECARE
ME
01
—
7238588
AETNA
—
Enumeration date
07/11/2006
Last updated
01/20/2016
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