Provider Demographics
NPI:1568621050
Name:MID MAINE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:MID MAINE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SAULTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-861-8221
Mailing Address - Street 1:81 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7338
Mailing Address - Country:US
Mailing Address - Phone:207-861-8221
Mailing Address - Fax:207-861-7900
Practice Address - Street 1:81 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-7338
Practice Address - Country:US
Practice Address - Phone:207-861-8221
Practice Address - Fax:207-861-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME128570000Medicaid