Individual
DR. SAMUEL E LARIVIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4 COMMONS AVE STE A, WINDHAM, ME 04062-5554
(207) 893-1738
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5571
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598248361
—
ME
Enumeration date
09/07/2018
Last updated
09/07/2021
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