Individual
DEREK BONENFANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 E MAIN ST, FORT KENT, ME 04743-1407
(207) 834-4117
(207) 834-3829
Mailing address
110 E MAIN ST, FORT KENT, ME 04743-1407
(207) 834-4117
(207) 834-3829
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4051
ME
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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