Organization
THE SPORTS THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRY G BRACKEN D.C. (OWNER)
(207) 221-3254
Entity
Organization
Contact information
Practice address
222 AUBURN ST, SUITE # 103, PORTLAND, ME 04103-6002
(207) 221-3254
Mailing address
16 CROSSMEADOW RD, SOUTH PORTLAND, ME 04106-6853
(207) 415-5621
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR1160
ME
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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