Provider Demographics
NPI:1861509010
Name:SARGENT, ERIK KRISTIAN (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:KRISTIAN
Last Name:SARGENT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 CUNDYS HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:HARPSWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04079-4306
Mailing Address - Country:US
Mailing Address - Phone:207-721-0485
Mailing Address - Fax:
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:126 T
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-623-5728
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist