Provider Demographics
NPI:1679857601
Name:CORRECTIVE MOTION CHIROPRACTIC AND REHABILITATION INC.
Entity Type:Organization
Organization Name:CORRECTIVE MOTION CHIROPRACTIC AND REHABILITATION INC.
Other - Org Name:CMCR
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-844-0365
Mailing Address - Street 1:1 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2492
Mailing Address - Country:US
Mailing Address - Phone:207-844-0365
Mailing Address - Fax:207-443-5855
Practice Address - Street 1:1 FRONT ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2492
Practice Address - Country:US
Practice Address - Phone:207-844-0365
Practice Address - Fax:207-443-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty