LISA FAVREAU

SO PORTLAND, ME
NPI1497790836
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ME  AT263)
Enumeration Date2006-06-19
Last Update Date2007-07-08
Business Address
-- LISA FAVREAU ATC
100 FODEN RD SUITE 103W
SO PORTLAND, ME 04106-2319
Phone number: 207-772-2625
Mailing Address
-- LISA FAVREAU ATC
100 FODEN RD SUITE 103W
SO PORTLAND, ME 04106-2319
Phone number: 207-772-2625