Organization
PROACTIVE PHYSICAL THERAPY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LACHANCE (PARTNER)
(207) 376-3000
Entity
Organization
Contact information
Practice address
1190 LISBON ST, UNIT 101, LEWISTON, ME 04240-5063
(207) 376-3000
(207) 376-3003
Mailing address
1190 LISBON ST, UNIT 101, LEWISTON, ME 04240-5063
(207) 376-3000
(207) 376-3003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/20/2011
Last updated
11/26/2013
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