Organization
MAINEHEALTH
Active
Other names
Maine Medical Center Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCAITE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
272 CONGRESS ST, PORTLAND, ME 04101
(207) 874-2466
(207) 774-4625
Mailing address
300 SOUTHBOROUGH DR, SUITE 201, SOUTH PORTLAND, ME 04106-6914
(207) 661-2000
(207) 661-2033
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432747700
—
ME
Enumeration date
01/26/2010
Last updated
05/11/2020
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