Organization
SPORT, SPINE & REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA GRACE WENTWORTH DC, ATC (OWNER)
(207) 439-9045
Entity
Organization
Contact information
Practice address
28 LEVESQUE DR, SUITE 9, ELIOT, ME 03903
(207) 439-9045
(207) 703-0289
Mailing address
28 LEVESQUE DR, SUITE 9, ELIOT, ME 03903-2078
(207) 439-9045
(207) 703-0289
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR1465
ME
Other
Enumeration date
02/18/2009
Last updated
06/13/2014
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