Individual
LORI ECKERSTORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
163 VAN BUREN RD, CARIBOU, ME 04736-3567
(207) 492-3451
(207) 498-1392
Mailing address
PO BOX 40, CARIBOU, ME 04736-0040
(207) 498-2359
(207) 498-3947
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA309
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12016304
CAQH
—
Enumeration date
03/09/2006
Last updated
09/19/2013
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