Individual
LAURA S PITTENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C, MPH
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 773-1728
Mailing address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 773-1728
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00733
RI
363A00000X
Physician Assistant
PA21741
CA
363A00000X
Physician Assistant
Primary
PA2248
ME
Other
Enumeration date
08/08/2011
Last updated
10/25/2021
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