Provider Demographics
NPI:1033372636
Name:CHASSE, SHARON M (PT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:CHASSE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:ME
Mailing Address - Zip Code:04739-0310
Mailing Address - Country:US
Mailing Address - Phone:207-444-5152
Mailing Address - Fax:207-444-2878
Practice Address - Street 1:3388 AROOSTOOK ROAD
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:ME
Practice Address - Zip Code:04739
Practice Address - Country:US
Practice Address - Phone:207-444-5152
Practice Address - Fax:207-444-2878
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist