Healthcare Provider Details

I. General information

NPI: 1700556834
Provider Name (Legal Business Name): SEYDOU SIGUE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 MAIN RD
BROWNVILLE ME
04414-3107
US

IV. Provider business mailing address

529 S PATTEN RD
PATTEN ME
04765-3007
US

V. Phone/Fax

Practice location:
  • Phone: 207-538-3700
  • Fax: 207-528-2595
Mailing address:
  • Phone: 207-538-3701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCR2764
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: