Individual
SYDNEY GRACE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1 ENTERPRISE DRIVE, BIDDEFORD, ME 04005-4239
(207) 951-3373
Mailing address
1 ENTERPRISE DRIVE, BIDDEFORD, ME 04005-4239
(207) 890-4304
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5967
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT5967
—
ME
Enumeration date
09/25/2021
Last updated
09/19/2023
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