Provider Demographics
NPI:1407128895
Name:BRIGGS, SHAUN M (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:M
Last Name:BRIGGS
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 1:16 PENN PLZ STE 22
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3620
Mailing Address - Country:US
Mailing Address - Phone:207-747-2633
Mailing Address - Fax:207-947-3721
Practice Address - Street 1:16 PENN PLZ STE 22
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3620
Practice Address - Country:US
Practice Address - Phone:207-747-2633
Practice Address - Fax:207-947-3721
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001906111N00000X
ME2389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor