Individual
LAURIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-3639
(207) 626-1827
Mailing address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 621-3639
(207) 626-1827
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1218
ME
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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