Provider Demographics
NPI:1508427162
Name:DAVIS PT: A BALANCED APPROACH, LLC
Entity Type:Organization
Organization Name:DAVIS PT: A BALANCED APPROACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYTLEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-333-5022
Mailing Address - Street 1:417 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4143
Mailing Address - Country:US
Mailing Address - Phone:207-513-7115
Mailing Address - Fax:207-333-5022
Practice Address - Street 1:368 MINOT AVE STE 3
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4331
Practice Address - Country:US
Practice Address - Phone:207-333-5022
Practice Address - Fax:207-333-5089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech