Provider Demographics
NPI:1376919225
Name:SLOCUM FAMILY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:SLOCUM FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-522-0702
Mailing Address - Street 1:26 BATH RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 BATH RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2618
Practice Address - Country:US
Practice Address - Phone:207-725-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty