Provider Demographics
NPI:1750741450
Name:BEAL, SETH PATRICK (MOT OTR/L)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:PATRICK
Last Name:BEAL
Suffix:
Gender:M
Credentials:MOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 GARTLEY ST
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ME
Mailing Address - Zip Code:04250
Mailing Address - Country:US
Mailing Address - Phone:207-353-6711
Mailing Address - Fax:
Practice Address - Street 1:33 MILL ST.
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ME
Practice Address - Zip Code:04250
Practice Address - Country:US
Practice Address - Phone:207-353-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2982225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist