Organization
PERFORMANCE PHYSICAL THERAPY AND SPORTS REHAB INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY LAWRENCE LIBBY PT, DPT (CEO/PHYSICAL THERAPIST)
(207) 356-9810
Entity
Organization
Contact information
Practice address
277 STATE ST, SUITE 1B, BANGOR, ME 04401-5439
(207) 356-9810
Mailing address
95 SUNSET STRIP, BREWER, ME 04412-1632
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4035
ME
Other
Enumeration date
11/14/2014
Last updated
11/14/2014
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