| Mr Thomas Joseph Boutaugh, MSPT | |
|
63-65 W Church St., Suite 71, Stevens, PA 17578 | |
| (717) 335-1016 | |
| Not Available |
| Full Name | Mr Thomas Joseph Boutaugh |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 63-65 W Church St., Stevens, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811955115 | NPI | - | NPPES |
| 248160000 | Medicaid | ME | |
| 100546 | Other | ME | ANTHEM |
| 7538245 | Other | ME | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT2423 (Maine) | Secondary |
| 225100000X | Physical Therapist | PT022319 (Pennsylvania) | Primary |
| Provider Name | Novacare Outpatient Rehabilitation East, Inc. |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1487010583 PECOS PAC ID: 3678480290 Enrollment ID: O20140220000935 |
| Provider Name | Phs Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1912300096 PECOS PAC ID: 9234454851 Enrollment ID: O20150202001629 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Thomas Joseph Boutaugh, MSPT 121 Norway Dr, Mohnton, PA 19540-8743 Ph: (207) 659-0857 | Mr Thomas Joseph Boutaugh, MSPT 63-65 W Church St., Suite 71, Stevens, PA 17578 Ph: (717) 335-1016 |
Erin Fisher, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 71 W Church St, Stevens, PA 17578 Phone: 717-335-1016 | |
Jessica Rogers, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 63 W Church St Ste 71, Stevens, PA 17578 Phone: 717-335-1016 | |
Meredith Hartz, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 71 W Church St, Stevens, PA 17578 Phone: 717-335-1016 | |
Emily Brewer, Physical Therapist Medicare: Medicare Enrolled Practice Location: 63 W Church St, Stevens, PA 17578 Phone: 717-335-1016 | |
Celeste Pedersen, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 71 W Church St, Stevens, PA 17578 Phone: 717-336-5262 | |
Derek James Sauder, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 65 W Church St Ste 71, Stevens, PA 17578 Phone: 717-333-5101 | |
Mr. Daniel Williams Johnson Iii, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 71 W Church St, Stevens, PA 17578 Phone: 717-336-5262 Fax: 717-336-3133 |