Individual
SCOTT R LAVALLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4 COMMONS AVE, WINDHAM, ME 04062-5554
(207) 892-7642
(207) 892-8440
Mailing address
4 COMMONS AVE, WINDHAM, ME 04062-5554
(207) 892-7642
(207) 892-8440
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1552
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040668
BC/BS OF MAINE
ME
Enumeration date
07/22/2005
Last updated
03/25/2013
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