Provider Demographics
NPI:1396584322
Name:SCARBOROUGH ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Entity type:Organization
Organization Name:SCARBOROUGH ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-321-9156
Mailing Address - Street 1:29 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9306
Mailing Address - Country:US
Mailing Address - Phone:207-883-2979
Mailing Address - Fax:
Practice Address - Street 1:29 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9306
Practice Address - Country:US
Practice Address - Phone:207-883-2979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy