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Organization

EXUBERANT LIVING, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CAROL J LANE PT (PRESIDENT)
(207) 992-4042
Entity
Organization

Contact information

Practice address
890 HAMMOND ST, BANGOR, ME 04401-4328
(207) 992-4042
(207) 992-4043
Mailing address
216 NORTH RD, DIXMONT, ME 04932-3212
(207) 992-4042
(207) 992-4043

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TO1993
ME

Other

Enumeration date
09/12/2006
Last updated
08/22/2020
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