Healthcare Provider Details

I. General information

NPI: 1659291466
Provider Name (Legal Business Name): FOUNDATION PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 ACADEMY ST
PRESQUE ISLE ME
04769-3170
US

IV. Provider business mailing address

16 HILLSIDE ST
PRESQUE ISLE ME
04769-2424
US

V. Phone/Fax

Practice location:
  • Phone: 207-551-6270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRADLEY ALA
Title or Position: FOUNDER/CEO
Credential: PT, DPT
Phone: 207-551-6270