Healthcare Provider Details
I. General information
NPI: 1689534117
Provider Name (Legal Business Name): SACO BAY ORTHOPAEDIC AND SPORTS PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 ALEWIVE PARK RD STE 1
KENNEBUNK ME
04043-6134
US
IV. Provider business mailing address
4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US
V. Phone/Fax
- Phone: 207-569-6843
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
JOHN
F
DUGGAN
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 717-972-1100