MEDICARE: HOSPITAL MANIPULATIVE SERVICE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508978248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL MANIPULATIVE SERVICE PA

Provider Business Mailing Address
First Line	:	47 PLEASANT VW
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040-4039
Country	:	US
Telephone Number	:	207-583-6103
Fax Number	:	207-583-6096

Provider Business Practice Location Address
First Line	:	47 PLEASANT VW
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040-4039
Country	:	US
Telephone Number	:	207-583-6103
Fax Number	:	207-583-6096

Authorized Official
Title or Position	:	OWNER
Name	:	BRYAN BECK
Credential	:	DO
Telephone Number	:	207-870-7627

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/14/2013

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1730487737 — LISA MARIE GRAHAM
Practice Location Address:

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Directions to “HOSPITAL MANIPULATIVE SERVICE PA ” Practice Location

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