Healthcare Provider Details

I. General information

NPI: 1619140381
Provider Name (Legal Business Name): DAMARISCOTTA CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 BRISTOL ROAD
DAMARISCOTTA ME
04543-4025
US

IV. Provider business mailing address

PO BOX 1117
DAMARISCOTTA ME
04543-1117
US

V. Phone/Fax

Practice location:
  • Phone: 207-563-5500
  • Fax: 207-563-5580
Mailing address:
  • Phone: 207-563-5500
  • Fax: 207-563-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberME643
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberCR643
License Number StateME

VIII. Authorized Official

Name: DR. MICHAEL F. GIGLIA
Title or Position: DOCTOR/OWNER
Credential: D.C.
Phone: 207-563-5500