Provider Demographics
NPI:1003408279
Name:TRUE NORTH CHIROPRACTIC PC
Entity Type:Organization
Organization Name:TRUE NORTH CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-272-9663
Mailing Address - Street 1:58 MAIN RD N
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1307
Mailing Address - Country:US
Mailing Address - Phone:207-272-9663
Mailing Address - Fax:
Practice Address - Street 1:58 MAIN RD N
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1307
Practice Address - Country:US
Practice Address - Phone:207-272-9663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty