Provider Demographics
NPI:1750558565
Name:FALDMAN CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:FALDMAN CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:FALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-985-3780
Mailing Address - Street 1:62 PORTLAND RD
Mailing Address - Street 2:SUITE 47
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6658
Mailing Address - Country:US
Mailing Address - Phone:207-985-3780
Mailing Address - Fax:207-985-2933
Practice Address - Street 1:62 PORTLAND RD
Practice Address - Street 2:SUITE 47
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6658
Practice Address - Country:US
Practice Address - Phone:207-985-3780
Practice Address - Fax:207-985-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MET31481Medicare UPIN