Provider Demographics
NPI:1174867105
Name:MAINELY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MAINELY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-650-2493
Mailing Address - Street 1:1000 SHORE RD
Mailing Address - Street 2:BLDG. 326
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1916
Mailing Address - Country:US
Mailing Address - Phone:207-650-2493
Mailing Address - Fax:
Practice Address - Street 1:1000 SHORE RD
Practice Address - Street 2:BLDG. 326
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-1916
Practice Address - Country:US
Practice Address - Phone:207-650-2493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty