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General NPI Number Information
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NPI Number | 1699633420
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Entity Type | Organization
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Legal Business Name | STAGG PERFORMANCE PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 200 EXPEDITION DR STE 1A
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City | SCARBOROUGH
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State | ME
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Zip | 04074-5514
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Country | US
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Telephone | 207-205-0853
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Fax | 877-685-0065
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Provider Business Mailing Address
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Address Line | 200 EXPEDITION DR STE 1A
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City | SCARBOROUGH
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State | ME
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Zip | 04074-5514
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Country | US
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Telephone | 207-205-0853
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Fax | 877-685-0065
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BRIANNA STAGG
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Credential | DPT
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Telephone | 207-205-0853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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