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Individual

LAUREN HEBERT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
60 WELD ST, DIXFIELD, ME 04224-9515
(207) 562-8048
(207) 562-7179
Mailing address
PO BOX 220, DIXFIELD, ME 04224-0220
(207) 562-8048
(207) 562-7179

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT314
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010562
BC/BS INDIVIDUAL #
ME
01
2022587
AETNA PROV #
ME
01
779004
TUFTS
ME
01
HEALTHCARE
HEALTHSOURCE PROV #
ME
Enumeration date
09/01/2005
Last updated
07/09/2007
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