Provider Demographics
NPI:1063034627
Name:VARECHA, ROBERT S II (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:VARECHA
Suffix:II
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3543
Mailing Address - Country:US
Mailing Address - Phone:815-557-7834
Mailing Address - Fax:
Practice Address - Street 1:322 ELM ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3009
Practice Address - Country:US
Practice Address - Phone:207-282-5233
Practice Address - Fax:207-282-1395
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-17
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty