Provider Demographics
NPI:1679902076
Name:BECKWITH, ERIKA JEANNE (DPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:JEANNE
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:JEANNE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 WING RD
Mailing Address - Street 2:
Mailing Address - City:LEVANT
Mailing Address - State:ME
Mailing Address - Zip Code:04456-4401
Mailing Address - Country:US
Mailing Address - Phone:207-944-9802
Mailing Address - Fax:
Practice Address - Street 1:12 STILLWATER AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3984
Practice Address - Country:US
Practice Address - Phone:207-945-2946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist