Provider Demographics
NPI:1689855306
Name:FIRST CHOICE FAMILY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:FIRST CHOICE FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:MACKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-225-2600
Mailing Address - Street 1:1355 AUBURN RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TURNER
Mailing Address - State:ME
Mailing Address - Zip Code:04282-3778
Mailing Address - Country:US
Mailing Address - Phone:207-225-2600
Mailing Address - Fax:207-225-2600
Practice Address - Street 1:1355 AUBURN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:TURNER
Practice Address - State:ME
Practice Address - Zip Code:04282-3778
Practice Address - Country:US
Practice Address - Phone:207-225-2600
Practice Address - Fax:207-225-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME3445492OtherAETNA
ME061096OtherBLUE CROSS
MEM24839OtherCIGNA
MEU87323OtherHARVARD PILGRIM
ME3445492OtherAETNA
ME061096OtherBLUE CROSS
MEU87323OtherHARVARD PILGRIM