Organization
SCARBOROUGH FAMILY PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD J BLANCHARD RT (PRESIDENT CLINICIAN)
(207) 883-8133
Entity
Organization
Contact information
Practice address
400 ENTERPRISE DRIVE, SUITE 4, SCARBOROUGH, ME 04074
(207) 883-8133
(207) 883-8226
Mailing address
400 ENTERPRISE DRIVE, SUITE 4, SCARBOROUGH, ME 04074
(207) 883-8133
(207) 883-8226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022643
BCBS
—
01
—
098899
BCBS
—
05
—
407410000
—
ME
01
—
AA32558
HARVARD PILGRIM
—
Enumeration date
02/16/2007
Last updated
02/04/2013
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