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General NPI Number Information
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NPI Number | 1568986099
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Entity Type | Organization
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Legal Business Name | ACTIVE BALANCE SPINE AND SPORTS CARE PLLC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1228 PORTLAND RD
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City | ARUNDEL
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State | ME
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Zip | 04046
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Country | US
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Telephone | 207-351-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 PORTLAND RD
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City | ARUNDEL
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State | ME
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Zip | 04046
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Country | US
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Telephone | 207-351-7300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN LINSTER
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Credential | DC
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Telephone | 207-351-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CR2307
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License Number State | ME
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