Provider Demographics
NPI:1821074139
Name:NADEAU, ROGER BERNARD (DC)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:BERNARD
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DC
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Other - Credentials:
Mailing Address - Street 1:11 W MAIN ST
Mailing Address - Street 2:SUITE 102 OLDE FIREHALL SQUEARE WHOLISTIC CHIROPRACTIC
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1250
Mailing Address - Country:US
Mailing Address - Phone:207-834-3011
Mailing Address - Fax:207-834-3011
Practice Address - Street 1:11 W MAIN ST
Practice Address - Street 2:SUITE 102 OLDE FIREHALL SQUARE
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1250
Practice Address - Country:US
Practice Address - Phone:207-834-3011
Practice Address - Fax:207-834-3011
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor