Organization
PROSPECT INC.
Active
Other names
Prospect Sports Medicine & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JAMES PICKLE MSPT (CEO)
(207) 626-3333
Entity
Organization
Contact information
Practice address
6 ROCKWOOD DR., SUITE #2, MANCHESTER, ME 04351-0552
(207) 626-3333
(207) 626-3334
Mailing address
6 ROCKWOOD DRIVE, SUITE #2, MANCHESTER, ME 04351-0552
(207) 626-3333
(207) 626-3334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2546
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060722
BLUE CROSS, BLUE SHIELD
ME
Enumeration date
01/24/2007
Last updated
08/22/2020
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