Provider Demographics
NPI:1720188576
Name:STAPLES, SYBIL MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SYBIL
Middle Name:MARIE
Last Name:STAPLES
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 1:124 MAINE ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2028
Mailing Address - Country:US
Mailing Address - Phone:207-729-4645
Mailing Address - Fax:
Practice Address - Street 1:124 MAINE ST
Practice Address - Street 2:SUITE 215
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2028
Practice Address - Country:US
Practice Address - Phone:207-729-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM4683Medicare ID - Type UnspecifiedPROVIDER ID
MEU39204Medicare UPIN