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Individual

BRIAN LAWRENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
16 SAINT LAWRENCE ST, PORTLAND, ME 04101-4316
(207) 318-1254
Mailing address
16 SAINT LAWRENCE ST, PORTLAND, ME 04101-4316
(207) 318-1254

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT4103
ME

Other

Enumeration date
02/02/2010
Last updated
02/02/2010
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