The Sports Therapy Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CR1160 Issued in ME

Legal business name

THE SPORTS THERAPY CENTER LLC

Practice address

222 Auburn St
Suite # 103
Portland, ME 04103-6002

Phone

(207) 221-3254

NPI assigned

Apr 24, 2008

Last updated

Apr 24, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Garry G Bracken, D.C.

Title

Owner

Phone

(207) 221-3254

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1699940205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CROSSMEADOW RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066853",
            "telephone_number": "207-415-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST",
            "address_2": "SUITE # 103",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036002",
            "telephone_number": "207-221-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPORTS THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "BRACKEN",
        "authorized_official_first_name": "GARRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-221-3254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Portland, ME
• Providers in Portland, ME by specialty
• Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.