Provider Demographics
NPI:1386512184
Name:SAVAGE, RICKY AARON (LMT)
Entity type:Individual
Prefix:
First Name:RICKY
Middle Name:AARON
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:AARON
Other - Last Name:MORIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 TUFTON ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-9112
Mailing Address - Country:US
Mailing Address - Phone:207-607-9789
Mailing Address - Fax:
Practice Address - Street 1:124 MAINE ST STE 19
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2048
Practice Address - Country:US
Practice Address - Phone:207-607-9789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT8063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist