Provider Demographics
NPI:1821378787
Name:HEALY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HEALY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HEALY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-989-4401
Mailing Address - Street 1:270 WILSON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1548
Mailing Address - Country:US
Mailing Address - Phone:207-989-4401
Mailing Address - Fax:207-989-4452
Practice Address - Street 1:270 WILSON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1548
Practice Address - Country:US
Practice Address - Phone:207-989-4401
Practice Address - Fax:207-989-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty