Provider Demographics
NPI:1588613608
Name:MORRISROE, CAITLIN M (DC)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:M
Last Name:MORRISROE
Suffix:
Gender:F
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:PO BOX 7640
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04112-7640
Mailing Address - Country:US
Mailing Address - Phone:207-669-2622
Mailing Address - Fax:207-699-2624
Practice Address - Street 1:1 CITY CTR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-6420
Practice Address - Country:US
Practice Address - Phone:207-699-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1590111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME158-861-3608Medicare UPIN