Organization
NORTHERN NEW ENGLAND PRIMARY CARE
Active
Other names
New England Sport and Spine, Maine Recovery Center, Vascular Center of New England
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS JOSEPH JORGENSEN (PRESIDENT, OWNER)
(207) 622-4500
Entity
Organization
Contact information
Practice address
29 BOWDOIN ST, MANCHESTER, ME 04351
(207) 622-4500
(207) 622-5452
Mailing address
29 BOWDOIN ST, MANCHESTER, ME 04351-3554
(207) 622-4500
(207) 622-5452
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
ME
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730187923
—
ME
Enumeration date
07/12/2005
Last updated
08/12/2019
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