Provider Demographics
NPI:1912164526
Name:BOLDCOAST CHIROPRACTIC CARE
Entity Type:Organization
Organization Name:BOLDCOAST CHIROPRACTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-347-3033
Mailing Address - Street 1:251 US ROUTE 1
Mailing Address - Street 2:STE W9B
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1322
Mailing Address - Country:US
Mailing Address - Phone:207-347-3033
Mailing Address - Fax:
Practice Address - Street 1:251 US ROUTE 1
Practice Address - Street 2:STE W9B
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1322
Practice Address - Country:US
Practice Address - Phone:207-347-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432377400OtherHARVARD PILGRIM
ME100303OtherANTHEM
ME4486691OtherCIGNA