Provider Demographics
NPI:1720128085
Name:CHASSE, DANIEL D (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:CHASSE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1446
Mailing Address - Country:US
Mailing Address - Phone:207-834-5121
Mailing Address - Fax:207-834-2477
Practice Address - Street 1:155 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1446
Practice Address - Country:US
Practice Address - Phone:207-834-5121
Practice Address - Fax:207-834-2477
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010514340OtherTAX ID
ME131100099Medicaid
ME131100099Medicaid
MEMM0759Medicare PIN