MEDICARE: COLLEEN MONROE LMT, DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	2947	ME
2	111N00000X	Chiropractor	CR2069	ME

General Provider Information

NPI Number	:	1912113150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN MONROE LMT, DC

Provider Business Mailing Address
First Line	:	38 LONGFELLOW DR
Second Line	:
City	:	CAPE ELIZABETH
State	:	ME
Zip	:	04107-2223
Country	:	US
Telephone Number	:	207-650-2493
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 SHORE RD
Second Line	:	BLDG 326
City	:	CAPE ELIZABETH
State	:	ME
Zip	:	04107-1916
Country	:	US
Telephone Number	:	207-650-2493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	04/06/2012

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Directions to “ COLLEEN MONROE LMT, DC” Practice Location

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