Lisa Favreau, ATC
NPI #1497790836 in So Portland, Maine
Provider Information
- NPI Number
- 1497790836
- Entity Type
- Individual
- Name
- Lisa Favreau, ATC
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Jun 19, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 100 FODEN RD
- Address 2
- SUITE 103W
- City
- So Portland
- State
- Maine
- ZIP Code
- 04106-2319
- Phone
- (207) 772-2625
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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