THE SPORTS THERAPY CENTER LLC (NPI# 1699940205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699940205 |
| Entity Type | Organization |
| Organization Name | THE SPORTS THERAPY CENTER LLC |
| Practice Address |
222 Auburn St Suite # 103 Portland ME 04103-6002 |
| Mailing Address |
16 Crossmeadow Rd South Portland ME 04106-6853 |
| Practice Telephone | 2072213254 |
| Mailing Telephone | 2074155621 |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |
| Authorized Official Name | DR. GARRY G BRACKEN (OWNER) |
| Authorized Official Telephone | 2072213254 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CR1160 | ME | Chiropractic Providers |
| Street Address |
222 AUBURN ST SUITE # 103 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346228509 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 222 Auburn St, Portland, ME 04103-6004 | 2006-01-06 |
| 1033766563 | Jacqueline R Delong | Speech-Language Pathologist | 222 Auburn St, Portland, ME 04103-6002 | 2019-08-20 |
| 1124688304 | Alice Hervey | Speech-Language Pathologist | 222 Auburn St, Portland, ME 04103-6002 | 2019-06-19 |
| 1497278683 | Katelyn Deblois | Speech-Language Pathologist | 222 Auburn St, Portland, ME 04103-6002 | 2017-07-20 |
| 1780126557 | Carolyn Branson Pllc | Counselor | 222 Auburn St, Suite 201, Portland, ME 04103-6002 | 2016-11-10 |
| 1710336318 | Heidi A Heap-chester Md LLC | Family Medicine | 222 Auburn St, Suite 102, Portland, ME 04103-6002 | 2016-06-06 |
| 1225403462 | Brittney Astbury | Speech-Language Pathologist | 222 Auburn St, Portland, ME 04103-6002 | 2015-12-13 |
| 1548634470 | Carolyn Branson | Counselor | 222 Auburn St, Ste. 201, Portland, ME 04103-6002 | 2015-11-16 |
| 1568847333 | Anastasia M. Valcourt | Speech-Language Pathologist | 222 Auburn St, Portland, ME 04103-6002 | 2015-07-22 |
| 1316332604 | Iris Savernik Do Osteopathic Care LLC | Neuromusculoskeletal Medicine & OMM | 222 Auburn St, Portland, ME 04103-6002 | 2015-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486958 | Amy Elizabeth Goebel | Chiropractor | 5103 Se Stark St Apt B, Portland, OR 97215-1764 | 2020-10-27 |
| 1003423914 | Evergreen Chiropractic PC | Chiropractor | 7145 Sw Varns St Ste 203, Portland, OR 97223-8168 | 2020-09-24 |
| 1750993283 | University of Western States Healthcare Inc | Chiropractor | 8000 Ne Tillamook St, Portland, OR 97213-6655 | 2020-08-17 |
| 1518587989 | Kristy Pearl Arneson | Chiropractor | 3715 Se Cesar E Chavez Blvd, Portland, OR 97202-1704 | 2020-04-25 |
| 1770102956 | Behireta Corbadzic | Chiropractor | 12923 Se Foster Rd Unit G703, Portland, OR 97236-4702 | 2020-04-08 |
| 1134754427 | Bonnie Anderson | Chiropractor | 3539 N Williams Ave Ste 202a, Portland, OR 97227-1437 | 2020-03-06 |
| 1629601372 | Megan Adele Robles | Chiropractor | 2100 Ne Broadway St Ste 255, Portland, OR 97232-1544 | 2020-02-20 |
| 1306479472 | Naomi M Enos-burles | Chiropractor | 7332 Sw 13th Dr Apt A, Portland, OR 97219-2089 | 2020-02-18 |
| 1184256927 | Michael Nicosia | Chiropractor | 207 Santa Monica St, Portland, TX 78374-2645 | 2020-02-10 |
| 1942832258 | Tracy Yvonne Still | Chiropractor | 3905b Ne Grand Ave Unit B, Portland, OR 97212-1107 | 2020-02-05 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on THE SPORTS THERAPY CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.