Provider Demographics
NPI:1356639645
Name:ADVANCED PHYSICAL THERAPY,LLC
Entity Type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMELIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-772-7662
Mailing Address - Street 1:50 SEWALL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2645
Mailing Address - Country:US
Mailing Address - Phone:207-772-7662
Mailing Address - Fax:207-772-0591
Practice Address - Street 1:152 US ROUTE 1 STE 9
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074
Practice Address - Country:US
Practice Address - Phone:207-772-7662
Practice Address - Fax:207-772-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty