Provider Demographics
NPI:1457370496
Name:PAUL E SAYOUR
Entity Type:Organization
Organization Name:PAUL E SAYOUR
Other - Org Name:WICKFORD CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAYOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-295-9767
Mailing Address - Street 1:610 TEN ROD ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02852
Mailing Address - Country:US
Mailing Address - Phone:401-295-9767
Mailing Address - Fax:401-295-0230
Practice Address - Street 1:610 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4206
Practice Address - Country:US
Practice Address - Phone:401-295-9767
Practice Address - Fax:401-295-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1457370496OtherGROUP NPI
RI1457370496OtherGROUP NPI
U49334Medicare UPIN