Provider Demographics
NPI:1629004544
Name:DOUCETTE, JOHN PHILIP (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PHILIP
Last Name:DOUCETTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 MAIN ST
Mailing Address - Street 2:STE 10
Mailing Address - City:MADAWASKA
Mailing Address - State:ME
Mailing Address - Zip Code:04756-1014
Mailing Address - Country:US
Mailing Address - Phone:207-728-7778
Mailing Address - Fax:207-728-7779
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:STE 10
Practice Address - City:MADAWASKA
Practice Address - State:ME
Practice Address - Zip Code:04756-1014
Practice Address - Country:US
Practice Address - Phone:207-728-7778
Practice Address - Fax:207-728-7779
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist