Individual
LAURA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
49 DARTMOUTH ST, SUITE 102, PORTLAND, ME 04101-1700
(207) 773-7788
Mailing address
49 DARTMOUTH ST, SUITE 102, PORTLAND, ME 04101-1700
(207) 773-7788
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT1356
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098930
ANTHEM
ME
Enumeration date
03/20/2007
Last updated
05/12/2009
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