Individual
JENNIFER L HAVERKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
151 MAIN ST, WESTBROOK, ME 04092-4808
(207) 854-1801
(207) 854-0260
Mailing address
151 MAIN ST, WESTBROOK, ME 04092-4808
(207) 854-1801
(207) 854-0260
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT902
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433071299
—
ME
Enumeration date
09/03/2008
Last updated
09/15/2011
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