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General NPI Number Information
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NPI Number | 1760629141
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Entity Type | Organization
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Legal Business Name | STONE COAST CHIROPRACTIC
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 52 CENTER ST
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City | PORTLAND
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State | ME
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Zip | 04101-3902
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Country | US
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Telephone | 207-781-7999
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Fax | 297-781-0941
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Provider Business Mailing Address
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Address Line | 52 CENTER ST
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City | PORTLAND
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State | ME
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Zip | 04101-3902
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Country | US
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Telephone | 207-781-7999
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Fax | 297-781-0941
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Authorized Official
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Title or Position | CHIROPRACTOR/PRESIDENT
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Name | DR. RACHEL ANNE STREIT
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Credential | D.C.
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Telephone | 207-781-7999
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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 | CR1764
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License Number State | ME
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