Provider Demographics
NPI:1821376534
Name:LAILER, WHITNEY G (DPT)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:G
Last Name:LAILER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04087-0456
Mailing Address - Country:US
Mailing Address - Phone:207-247-3216
Mailing Address - Fax:207-247-3217
Practice Address - Street 1:392 MAIN ST.
Practice Address - Street 2:
Practice Address - City:WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04087
Practice Address - Country:US
Practice Address - Phone:207-247-3216
Practice Address - Fax:207-247-3217
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist