Provider Demographics
NPI:1932571254
Name:SYNAPTIC CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:SYNAPTIC CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-578-1284
Mailing Address - Street 1:690 STROUDWATER ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:690 STROUDWATER ST
Practice Address - Street 2:UNIT 3
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4049
Practice Address - Country:US
Practice Address - Phone:207-578-1284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty