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General NPI Number Information
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NPI Number | 1215123914
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Entity Type | Organization
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Legal Business Name | TO LIFE CHIROPRACTIC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 190 US ROUTE 1
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City | FALMOUTH
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State | ME
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Zip | 04105-1313
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Country | US
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Telephone | 207-781-8008
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Fax | 207-781-3233
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Provider Business Mailing Address
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Address Line | 190 US ROUTE 1
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City | FALMOUTH
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State | ME
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Zip | 04105-1313
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Country | US
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Telephone | 207-781-8008
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Fax | 207-781-3233
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL ANDREW PERREAULT
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Credential | DC
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Telephone | 207-781-8008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CR1334
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License Number State | ME
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