Provider Demographics
NPI:1508978248
Name:HOSPITAL MANIPULATIVE SERVICE PA
Entity Type:Organization
Organization Name:HOSPITAL MANIPULATIVE SERVICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-870-7627
Mailing Address - Street 1:47 PLEASANT VW
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:ME
Mailing Address - Zip Code:04040-4039
Mailing Address - Country:US
Mailing Address - Phone:207-583-6103
Mailing Address - Fax:207-583-6096
Practice Address - Street 1:47 PLEASANT VW
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:ME
Practice Address - Zip Code:04040-4039
Practice Address - Country:US
Practice Address - Phone:207-583-6103
Practice Address - Fax:207-583-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30213009Medicaid
ME329760000Medicaid
ME329760000Medicaid
MECJ4306Medicare PIN