Individual
AMY L. BARRACLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2381
Mailing address
360 US HIGHWAY 1 BYP UNIT 102, PORTSMOUTH, NH 03801-7105
(603) 410-6700
(603) 319-8308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1238
WI
363A00000X
Physician Assistant
Primary
1980
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42996500
—
WI
Enumeration date
05/11/2006
Last updated
11/14/2023
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