Healthcare Provider Details

I. General information

NPI: 1528460284
Provider Name (Legal Business Name): ROSS AARON LEVESQUE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S PATTEN RD
PATTEN ME
04765-3007
US

IV. Provider business mailing address

529 S PATTEN RD
PATTEN ME
04765-3007
US

V. Phone/Fax

Practice location:
  • Phone: 207-538-3700
  • Fax: 207-528-2880
Mailing address:
  • Phone: 207-538-3700
  • Fax: 207-528-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4180
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: