Healthcare Provider Details

I. General information

NPI: 1518013275
Provider Name (Legal Business Name): ATLANTIC PROSTHETIC AND ORTHOTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1274 CONGRESS ST
PORTLAND ME
04102-2111
US

IV. Provider business mailing address

1274 CONGRESS ST
PORTLAND ME
04102-2111
US

V. Phone/Fax

Practice location:
  • Phone: 207-774-1002
  • Fax: 207-774-9002
Mailing address:
  • Phone: 207-774-1002
  • Fax: 207-774-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberCPO 1271
License Number StateME

VIII. Authorized Official

Name: IVAN SABEL
Title or Position: CEO
Credential:
Phone: 207-774-1002