Healthcare Provider Details

I. General information

NPI: 1437070240
Provider Name (Legal Business Name): MAINE PERFORMANCE AND LONGEVITY CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 MAIN RD N STE A
HAMPDEN ME
04444-1831
US

IV. Provider business mailing address

31 BOWEN DR
HAMPDEN ME
04444-1057
US

V. Phone/Fax

Practice location:
  • Phone: 207-356-5222
  • Fax:
Mailing address:
  • Phone: 207-356-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. ZACHARY MITCHELL GREENIER
Title or Position: FOUNDER AND OWNER
Credential: PA-C
Phone: 207-356-5222