Provider Demographics
NPI:1609511492
Name:MAINE ASCENT PHYSICAL THERAPY & WELLNESS
Entity Type:Organization
Organization Name:MAINE ASCENT PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERSCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:603-491-8423
Mailing Address - Street 1:81 BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:KITTERY POINT
Mailing Address - State:ME
Mailing Address - Zip Code:03905-5650
Mailing Address - Country:US
Mailing Address - Phone:603-491-8423
Mailing Address - Fax:
Practice Address - Street 1:81 BARTLETT RD
Practice Address - Street 2:
Practice Address - City:KITTERY POINT
Practice Address - State:ME
Practice Address - Zip Code:03905-5650
Practice Address - Country:US
Practice Address - Phone:207-200-1484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-05
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty