Provider Demographics
NPI:1619027646
Name:ARSENAULT, STEPHEN TG (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:TG
Last Name:ARSENAULT
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 1:85 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:VEAZIE
Mailing Address - State:ME
Mailing Address - Zip Code:04401-7031
Mailing Address - Country:US
Mailing Address - Phone:207-990-5069
Mailing Address - Fax:
Practice Address - Street 1:15 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-3652
Practice Address - Country:US
Practice Address - Phone:207-866-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM7226Medicare UPIN