Provider Demographics
NPI:1083903876
Name:TUBBS, BETH E (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:E
Last Name:TUBBS
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 1:175 UNION ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6100
Mailing Address - Country:US
Mailing Address - Phone:207-992-4000
Mailing Address - Fax:207-669-8302
Practice Address - Street 1:175 UNION ST
Practice Address - Street 2:SUITE A
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6100
Practice Address - Country:US
Practice Address - Phone:207-992-4000
Practice Address - Fax:207-669-8302
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1729 ME225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist