Provider Demographics
NPI:1740479880
Name:NADEAU, RYAN THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:THOMAS
Last Name:NADEAU
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 1:9 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2247
Mailing Address - Country:US
Mailing Address - Phone:207-725-7177
Mailing Address - Fax:207-725-5600
Practice Address - Street 1:9 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2247
Practice Address - Country:US
Practice Address - Phone:207-725-7177
Practice Address - Fax:207-725-5600
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1837111N00000X
PADC011363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
11841577OtherCAQH