Individual
MAUREEN M BOURQUE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
5 FUNDY RD, FALMOUTH, ME 04105-1704
(207) 781-8358
(207) 781-8357
Mailing address
5 FUNDY RD, FALMOUTH, ME 04105-1704
(207) 781-8358
(207) 781-8357
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME115227
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11538314
CAQH
ME
Enumeration date
01/25/2006
Last updated
07/08/2007
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