Healthcare Provider Details

I. General information

NPI: 1649000811
Provider Name (Legal Business Name): ABIGAIL MARGARET LEBLANC PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 08/03/2024
Certification Date: 08/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CASCADE RD
SACO ME
04072-9000
US

IV. Provider business mailing address

6 CANTARA AVE
SACO ME
04072-2622
US

V. Phone/Fax

Practice location:
  • Phone: 207-284-5700
  • Fax:
Mailing address:
  • Phone: 207-205-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT6912
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: