Provider Demographics
NPI:1013097716
Name:CYR, MAURICE JOSEPH (DC FICC)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:JOSEPH
Last Name:CYR
Suffix:
Gender:M
Credentials:DC FICC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 STRATTON RD
Mailing Address - Street 2:PHYSICAL REHABILITATION AND HEALTH CENTER
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701
Mailing Address - Country:US
Mailing Address - Phone:802-775-6961
Mailing Address - Fax:802-773-9668
Practice Address - Street 1:245 STRATTON RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4621
Practice Address - Country:US
Practice Address - Phone:802-775-6961
Practice Address - Fax:802-773-9668
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060000734111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVT2507OtherMEDICARE LEGACY
VTVT2507OtherBCBS
VTT25350Medicare UPIN