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Individual

LAURA ANN LEBOURDAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
887 CONGRESS ST, PORTLAND, ME 04102-3100
(207) 774-6368
(207) 774-9388
Mailing address
56 EXCHANGE ST APT 33, PORTLAND, ME 04101-5032
(207) 522-5964

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
07/21/2017
Last updated
03/17/2018
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