Provider Demographics
NPI:1659539666
Name:ST CYR, NICOLE LAUREE (DC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:LAUREE
Last Name:ST CYR
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 1:139 SOUTH MAIN STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415
Mailing Address - Country:US
Mailing Address - Phone:860-346-1160
Mailing Address - Fax:860-346-1160
Practice Address - Street 1:139 SOUTH MAIN STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415
Practice Address - Country:US
Practice Address - Phone:860-346-1160
Practice Address - Fax:860-346-1160
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor