Individual
LISA J REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
400 ENTERPRISE DRIVE, SUITE 3, SCARBOROUGH, ME 04074
(207) 883-8133
(207) 883-8226
Mailing address
400 ENTERPRISE DRIVE, SUITE 3, SCARBOROUGH, ME 04074
(207) 883-8133
(207) 883-8226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1503
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA32558
HARVARD PILGRIM
—
Enumeration date
01/12/2007
Last updated
07/08/2007
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