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Individual

MS. LISA ANNE JACUNSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
23 CEDAR RIDGE DR, SKOWHEGAN, ME 04976-4160
(207) 474-9686
Mailing address
54 OAK HILL DR, OAKLAND, ME 04963-5004
(207) 465-9681

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA2932
ME

Other

Enumeration date
03/20/2007
Last updated
07/08/2007
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