Gouldsbrough, Lisa

Gouldsbrough, Lisa is an individual health care provider with primary practice located at 3 Shape Drive 2Nd Floor, Kennebunk ME 04043. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gouldsbrough, Lisa can be contacted via phone (207) 467-8930.

Contact Information

Primary practice address
3 Shape Drive 2Nd Floor Kennebunk ME 04043
Phone: (207) 467-8930
Fax: (467) 985-8459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 1395 Maine

Profile Details

NPI number 1255317897
LBN Legal business name Gouldsbrough, Lisa
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Oct 27th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255317897 NPPES
Maine MEDICAID 242320099

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