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General NPI Number Information
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NPI Number | 1407794605
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Entity Type | Individual
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Provider Name | DONALD ANDRE LETELLIER
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Gender | Male
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 366 MAIN ST
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City | WATERBORO
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State | ME
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Zip | 04087-3057
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Country | US
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Telephone | 207-251-3798
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Fax |
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Provider Business Mailing Address
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Address Line | 94 OSSIPEE HILL RD
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City | EAST WATERBORO
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State | ME
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Zip | 04030-5050
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Country | US
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Telephone | 207-608-3798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT5606
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License Number State | ME
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