Healthcare Provider Details

I. General information

NPI: 1902956402
Provider Name (Legal Business Name): BIBC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 PENN PLZ STE 22
BANGOR ME
04401-3620
US

IV. Provider business mailing address

16 PENN PLZ STE 22
BANGOR ME
04401-3620
US

V. Phone/Fax

Practice location:
  • Phone: 207-947-8077
  • Fax: 207-947-3721
Mailing address:
  • Phone: 207-947-8077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCR1314
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA A. BABIN-GOODEN
Title or Position: BUSINESS OWNER
Credential:
Phone: 207-947-8077