Organization
ORTHOPEDIC & SPINE PHYSICAL THERAPY OF L/A INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAN MARTIN TEIXEIRA PT, MOMT,OCS (PHYSICAL THERAPIST/ OWNER)
(207) 777-3002
Entity
Organization
Contact information
Practice address
581 MAIN ST, SUITE 1, LEWISTON, ME 04240-5945
(207) 777-3002
(207) 777-3004
Mailing address
581 MAIN ST, SUITE 1, LEWISTON, ME 04240-5945
(207) 777-3002
(207) 777-3004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2321
ME
Other
Enumeration date
05/25/2006
Last updated
12/09/2010
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