Individual
BRIANNA LEE KAULBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
225 GORHAM RD STE 200, SOUTH PORTLAND, ME 04106-2462
(800) 757-3326
(207) 400-8891
Mailing address
225 GORHAM RD STE 200, SOUTH PORTLAND, ME 04106-2462
(800) 757-3326
(207) 400-8891
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA4909
ME
Other
Enumeration date
06/24/2021
Last updated
10/01/2023
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