Individual
KARI VANDERHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
465 MAIN ST, LEWISTON, ME 04240-6738
(207) 777-5370
Mailing address
PO BOX 1028, AUBURN, ME 04211-1028
(207) 777-5370
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT5373
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200776944
TAX ID
ME
Enumeration date
06/12/2017
Last updated
06/12/2017
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