Provider Demographics
NPI:1538968623
Name:LAMONTAGNE, NOLAN ERIK
Entity type:Individual
Prefix:
First Name:NOLAN
Middle Name:ERIK
Last Name:LAMONTAGNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04087-3057
Mailing Address - Country:US
Mailing Address - Phone:207-247-3216
Mailing Address - Fax:
Practice Address - Street 1:392 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04087-3057
Practice Address - Country:US
Practice Address - Phone:207-247-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist