Provider Demographics
NPI:1477625382
Name:SAUCIER, TINA M I (PT)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:M
Last Name:SAUCIER
Suffix:I
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 1:239 U S ROUTE 1
Mailing Address - Street 2:P O BOX 64
Mailing Address - City:FRENCHVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04745-0064
Mailing Address - Country:US
Mailing Address - Phone:207-728-6841
Mailing Address - Fax:
Practice Address - Street 1:37 CARTER STREET
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:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME044747OtherBLUE CROSS