Individual
LYNETTE ROSE GODBOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
102 CAMPUS AVE, LEWISTON, ME 04240-6019
(207) 777-4219
Mailing address
307 ROUTE 135, MONMOUTH, ME 04259-6518
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA2302
ME
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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