Provider Demographics
NPI:1790224475
Name:BENJAMIN J. MYEROWITZ DC LLC
Entity Type:Organization
Organization Name:BENJAMIN J. MYEROWITZ DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MYEROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-989-0000
Mailing Address - Street 1:291 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04429-7132
Mailing Address - Country:US
Mailing Address - Phone:207-989-0000
Mailing Address - Fax:207-989-7459
Practice Address - Street 1:291 MAIN RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:ME
Practice Address - Zip Code:04429-7132
Practice Address - Country:US
Practice Address - Phone:207-989-0000
Practice Address - Fax:207-989-7459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service