Organization
ADVANTAGE PHYSICAL THERAPY & PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCAS J DAVENPORT PT (OWNER)
(207) 944-5654
Entity
Organization
Contact information
Practice address
10 DYNAMIC DR STE 2, SCARBOROUGH, ME 04074-6594
(207) 944-5654
Mailing address
125 BRICKHILL AVE UNIT 124, SOUTH PORTLAND, ME 04106-2194
(207) 944-5654
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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