Provider Demographics
NPI:1962009993
Name:BOLDUC, APRIL JODIE (PT)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:JODIE
Last Name:BOLDUC
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-4826
Mailing Address - Country:US
Mailing Address - Phone:207-576-6956
Mailing Address - Fax:
Practice Address - Street 1:1190 LISBON ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5063
Practice Address - Country:US
Practice Address - Phone:207-376-3000
Practice Address - Fax:207-376-3003
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist