- Practice location
- 200 Sanford RD, Wells, ME 04090-5534
- Phone
- 973-600-3147
- Fax
- —
- Last updated
- August 12, 2025
Ethan W Dispoto is a Specialist/Technologist, Athletic Trainer based in Wells, ME. Ethan W Dispoto practices in Wells, ME and has the professional credentials of ATC, LAT. The NPI Number for Ethan W Dispoto is 1316823776 and holds a License No. AT960 (ME). The current practice location address for Ethan W Dispoto is 200 Sanford RD, Wells, ME 04090-5534 and can be reached out via phone at 973-600-3147.
Provider Profile Details
- NPI Number
- 1316823776
- Provider Name
- Ethan W Dispoto
- Credential
- ATC, LAT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 200 Sanford RD, Wells, ME 04090-5534
- Phone Number
- 973-600-3147
- Primary Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 12, 2025
- Last Update Date
- August 12, 2025
- Certification Date
- August 12, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 200 Sanford RD
Wells, ME 04090-5534 - City
- Wells
- State
- Maine
- Zip
- 04090-5534
- Phone Number
- 973-600-3147
Provider Business Mailing Address Details
- Address
- 88 Buena Vista Dr
Ringwood, NJ 07456-2028 - City
- Ringwood
- State
- NJ
- Zip
- 07456-2028
- Phone Number
- 973-600-3147
License Information
- License Number
- AT960
- License State
- ME
- Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mr. Ethan W Dispoto, ATC, LAT?
The NPI number of Mr. Ethan W Dispoto, ATC, LAT is 1316823776. It was assigned on August 12, 2025 and is currently active in the NPPES registry.
What is the specialty of Mr. Ethan W Dispoto, ATC, LAT?
Mr. Ethan W Dispoto, ATC, LAT is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X), licensed in ME under license number AT960.
Where does Mr. Ethan W Dispoto, ATC, LAT practice?
The practice location is 200 Sanford RD, Wells, ME 04090-5534. The office can be reached at 973-600-3147 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316823776 directly on the NPPES registry website.