MEDICARE: KEVIN CHASSE DC, 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	111N00000X	Chiropractor	CR864	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350024329	OTHER	ME	PALMETTO MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	M2072	OTHER	ME	CIGNA
3	047926	OTHER	ME	ANTHEM BLUECROSS BLUESHIE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	2649247	OTHER	ME	AETNA

General Provider Information

NPI Number	:	1659552180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN CHASSE DC, PA

Provider Business Mailing Address
First Line	:	PO BOX 67
Second Line	:
City	:	DOVER FOXCROFT
State	:	ME
Zip	:	04426-0067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 E MAIN ST
Second Line	:
City	:	DOVER FOXCROFT
State	:	ME
Zip	:	04426-1323
Country	:	US
Telephone Number	:	207-564-2211
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KEVIN PAUL CHASSE
Credential	:	DC
Telephone Number	:	207-564-2211

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	11/22/2010

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Directions to “KEVIN CHASSE DC, PA ” Practice Location

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