Provider Demographics
NPI:1164547568
Name:CHANCEY, DEAN A (DC)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:A
Last Name:CHANCEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 WILTON RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6137
Mailing Address - Country:US
Mailing Address - Phone:207-778-0182
Mailing Address - Fax:207-779-0770
Practice Address - Street 1:586 WILTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6137
Practice Address - Country:US
Practice Address - Phone:207-778-0182
Practice Address - Fax:207-779-0770
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME229090001Medicaid
MEMM9004Medicare ID - Type Unspecified