Organization
THE MOG LLC
Active
Other names
United Medical Gym, Momentum Performance
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER S PRIBISH ATC, CSCS, CSAC (OWNER)
(207) 347-3030
Entity
Organization
Contact information
Practice address
125 JOHN ROBERTS RD STE 16, SOUTH PORTLAND, ME 04106-6983
(207) 347-3030
(207) 536-4449
Mailing address
125 JOHN ROBERTS RD STE 16, SOUTH PORTLAND, ME 04106-6983
(207) 347-3030
(207) 536-4449
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT241
ME
2255A2300X
Athletic Trainer
Primary
AT433
ME
2255A2300X
Athletic Trainer
AT500
ME
Other
Enumeration date
01/03/2018
Last updated
06/16/2018
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