Organization
MID-COAST SPINE & SPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY R FERGOLA DC (OWNER)
(207) 357-4541
Entity
Organization
Contact information
Practice address
18 WEST ST, BOOTHBAY HARBOR, ME 04538-1849
(207) 357-4541
Mailing address
14 MARDEN RD, BOOTHBAY HARBOR, ME 04538
(207) 357-4541
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/03/2019
Last updated
06/17/2020
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