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General NPI Number Information
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NPI Number | 1578646782
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE FOOT AND ANKLE CENTER PC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 23 SPRING ST SUITE B
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7701
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Country | US
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Telephone | 207-774-0028
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Fax | 207-774-0063
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Provider Business Mailing Address
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Address Line | 23 SPRING ST SUITE B
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7701
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Country | US
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Telephone | 207-774-0028
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Fax | 207-774-0063
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MICHELE N. KURLANSKI
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Credential | D.P.M.
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Telephone | 207-774-0028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1047
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License Number State | ME
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