Provider Demographics
NPI:1548765928
Name:BECKER, BARBARA JK (DPT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JK
Last Name:BECKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:KITCHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:73 OAK ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04461-3309
Mailing Address - Country:US
Mailing Address - Phone:207-341-0433
Mailing Address - Fax:
Practice Address - Street 1:335 STILLWATER AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3944
Practice Address - Country:US
Practice Address - Phone:207-947-1111
Practice Address - Fax:207-947-7605
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist