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General NPI Number Information
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NPI Number | 1730510090
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Entity Type | Organization
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Legal Business Name | AMES CHIROPRACTIC WELLNESS CENTER
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 804 STILLWATER AVE
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City | BANGOR
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State | ME
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Zip | 04401-3614
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Country | US
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Telephone | 207-907-2637
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Fax | 207-990-2308
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Provider Business Mailing Address
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Address Line | 804 STILLWATER AVE
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City | BANGOR
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State | ME
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Zip | 04401-3614
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Country | US
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Telephone | 207-907-2637
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Fax | 207-990-2308
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICKIE L AMES
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Credential | DC
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Telephone | 207-907-2637
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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 | CR 1914
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License Number State | ME
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