Individual
RURIK SAMUAL BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
331 VERANDA ST STE 401, PORTLAND, ME 04103-5545
(207) 536-0702
(207) 536-0785
Mailing address
73 NEWTON RD UNIT 101, PLAISTOW, NH 03865-2440
(978) 388-7272
(978) 388-7373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6670
ME
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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