Individual
JILLIAN WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
119 LIVERMORE FALLS RD, FARMINGTON, ME 04938-6241
(207) 778-6591
Mailing address
1379 NEW SHARON RD, STARKS, ME 04911-4516
(207) 280-4029
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA5707
ME
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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