MEDICARE: SARAH M SPENCER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	4484	ME

General Provider Information

NPI Number	:	1225572357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH M SPENCER PT

Provider Business Mailing Address
First Line	:	2 MOUNTAIN ASH AVE
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-9376
Country	:	US
Telephone Number	:	201-563-1971
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 BOWDOIN MILL IS
Second Line	:	#220
City	:	TOPSHAM
State	:	ME
Zip	:	04086-1263
Country	:	US
Telephone Number	:	207-729-1164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2016
Last Update Date	:	12/08/2016

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Directions to “ SARAH M SPENCER PT” Practice Location

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