Individual
LYNETTE BASSETT WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
43 TODD BROOK RD, FREEPORT, ME 04032-6253
(207) 869-9119
(207) 869-9117
Mailing address
43 TODD BROOK RD, FREEPORT, ME 04032-6253
(207) 869-9119
(207) 536-2112
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
1854
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432047699
—
ME
Enumeration date
07/24/2006
Last updated
05/19/2016
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