# MIGUEL VELAZQUEZ DO, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Osteopathic Sport & Spine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174855449
- **Authorized official:** DR. MIGUEL VELAZQUEZ D.O. (OWNER/PHYSICIAN)
- **Authorized official phone:** (207) 854-8200

## Contact information

- **Practice address:** 344 CUMBERLAND ST, WESTBROOK, ME 04092-2408
- **Practice address phone:** (207) 854-8200
- **Practice address fax:** (877) 735-2638
- **Mailing address:** 344 CUMBERLAND ST, WESTBROOK, ME 04092-2408
- **Mailing address phone:** (207) 854-8200
- **Mailing address fax:** (877) 735-2638

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 1761 | ME | Yes |

## Other

- **Enumeration date:** 02/11/2010
- **Last updated:** 02/11/2010