Healthcare Provider Details

I. General information

NPI: 1881518967
Provider Name (Legal Business Name): THE EMPOWERED PELVIC SANCTUARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 S MAIN ST UNIT 8
BREWER ME
04412-2307
US

IV. Provider business mailing address

117 PIRATES COVE RD
STOCKTON SPRINGS ME
04981-4159
US

V. Phone/Fax

Practice location:
  • Phone: 847-219-6278
  • Fax:
Mailing address:
  • Phone: 847-219-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ZENOBIA ZUBIN TANTRA
Title or Position: OWNER PROVIDER
Credential: DPT
Phone: 847-219-6278