Individual
LORRAYNE MASTRANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1685 CONGRESS ST, PORTLAND, ME 04102-2100
(207) 780-8860
(207) 780-8857
Mailing address
100 FODEN RD E, SUITE 201, SOUTH PORTLAND, ME 04106
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1821
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4251273
AETNA
—
01
—
622556
ANTHEM
—
Enumeration date
07/11/2006
Last updated
07/08/2007
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