Provider Demographics
NPI:1982719977
Name:DIONNE, LUC JASMINE (DC)
Entity Type:Individual
Prefix:MR
First Name:LUC
Middle Name:JASMINE
Last Name:DIONNE
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 1:120 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6053
Mailing Address - Country:US
Mailing Address - Phone:207-786-0393
Mailing Address - Fax:207-795-0661
Practice Address - Street 1:120 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6053
Practice Address - Country:US
Practice Address - Phone:207-786-0393
Practice Address - Fax:207-795-0661
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor