MEDICARE: JEAN E BEATTIE P.T.

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	ME 58261	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811106545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN E BEATTIE P.T.

Provider Business Mailing Address
First Line	:	PO BOX 1367
Second Line	:
City	:	WALDOBORO
State	:	ME
Zip	:	04572-1367
Country	:	US
Telephone Number	:	207-832-5544
Fax Number	:	207-832-5507

Provider Business Practice Location Address
First Line	:	1607 ATLANTIC HWY
Second Line	:
City	:	WALDOBORO
State	:	ME
Zip	:	04572-6023
Country	:	US
Telephone Number	:	207-832-5544
Fax Number	:	207-832-5507

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	04/21/2017

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Directions to “ JEAN E BEATTIE P.T.” Practice Location

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