| Full Name | |
|---|---|
| Speciality | Physical Therapist |
| Location | 248 State Street, Brewer, Maine |
| Authorized Official Name and Position | Scott Mayo (PRESIDENT) |
| Authorized Official Contact | 2079892034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
920 Ridgebrook Rd Sparks MD 21152-9390 Ph: (410) 773-1000 | 248 State Street Brewer ME 04412 Ph: (207) 989-2034 |
| NPI Number | 1700975331 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 06/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700975331 | NPI | - | NPPES |
| 163490002 | Medicaid | ME | |
| 99911053 | Medicaid | ME |
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