Organization
LIVEVITAL PHYSICAL THERAPY & PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID T KNOP PT (OWNER/PRESIDENT)
(207) 749-0617
Entity
Organization
Contact information
Practice address
40 MAPLE STREET, PORTLAND, ME 04101
(207) 749-0617
Mailing address
40 MAPLE STREET, PORTLAND, ME 04101
(207) 749-0617
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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