Individual
JASON G LANOUETTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
94 AUBURN STREET, #103, PORTLAND, ME 04103
(207) 797-7578
(207) 797-8165
Mailing address
3 CARNOUSTIE DRIVE, FALMOUTH, ME 04105
(207) 878-8925
(207) 797-8165
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
799
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036569
ANTHEM
—
Enumeration date
03/15/2006
Last updated
07/08/2007
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