Provider Demographics
NPI:1376684035
Name:ADVANCED CHIROPRACTIC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:PLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-490-1530
Mailing Address - Street 1:7 WOODVALE CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083-1147
Mailing Address - Country:US
Mailing Address - Phone:207-653-1738
Mailing Address - Fax:
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:SUITE # 2
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1818
Practice Address - Country:US
Practice Address - Phone:207-490-1530
Practice Address - Fax:207-490-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty