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General NPI Number Information
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NPI Number | 1588826036
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Entity Type | Organization
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Legal Business Name | CHANDRA SASSEVILLE DC PA
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 416 SABATTUS ST
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City | LEWISTON
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State | ME
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Zip | 04240-5430
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Country | US
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Telephone | 207-777-3333
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Fax | 207-786-8921
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Provider Business Mailing Address
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Address Line | 416 SABATTUS ST
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City | LEWISTON
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State | ME
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Zip | 04240-5430
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Country | US
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Telephone | 207-777-3333
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Fax | 207-786-8921
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ROBYN L COLEMAN
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Credential |
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Telephone | 207-777-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME421903
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License Number State | ME
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