Healthcare Provider Details
I. General information
NPI: 1538431861
Provider Name (Legal Business Name): DOIRON CHIROPRACTIC & SPORTS REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2012
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 ELM ST
BIDDEFORD ME
04005-3009
US
IV. Provider business mailing address
322 ELM ST
BIDDEFORD ME
04005-3009
US
V. Phone/Fax
- Phone: 207-282-5233
- Fax: 207-282-1395
- Phone: 207-282-5233
- Fax: 207-282-1395
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CR2031 |
| License Number State | ME |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
GEOFFREY
DOIRON
Title or Position: OWNER, PROVIDER
Credential: DC
Phone: 207-282-5233