MEDICARE: MARYANNE CORMIER DC

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	236-0686C	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04-65350	OTHER	NH	UNITED HEALTHCARE
2	020417401	OTHER	NH	NGS AMERICAN
3	1163089	OTHER	NH	FIRST HEALTH
4	Y39724	OTHER	NH	BCBS MA
5	020417401	OTHER	NH	BENEFIT ADMINISTRATORS
6	0504627Y0NH01	OTHER	NH	ANTHEM
7	544350	OTHER	NH	AETNA
8	NA1572	OTHER	NH	HARVARD PILGRIM
9	GA44-04092	OTHER	NH	UNITED HEALTHCARE- GA
10	020417401	OTHER	NH	HEALTHCARE MANAGEMENT
11	5411	OTHER	NH	CIGNA
12	020417401	OTHER	NH	GREAT WEST
13	020417401	OTHER	NH	MAIL HANDLERS
14	020417401	OTHER	NH	UNICARE
15	761532	OTHER	NH	TUFTS HEALTH PLAN
16	RE2188	OTHER	NH	BCBS MA

General Provider Information

NPI Number	:	1841204583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANNE CORMIER DC

Provider Business Mailing Address
First Line	:	58 RANGE RD
Second Line	:
City	:	WINDHAM
State	:	NH
Zip	:	03087-2026
Country	:	US
Telephone Number	:	603-893-6310
Fax Number	:	603-892-2841

Provider Business Practice Location Address
First Line	:	58 RANGE RD
Second Line	:
City	:	WINDHAM
State	:	NH
Zip	:	03087-2026
Country	:	US
Telephone Number	:	603-893-6310
Fax Number	:	603-893-2841

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/08/2007

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Practice Location Address:

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1427071927 — ROSANNE WASHINGTON PA
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1619078185 — MR. MICHAEL E KNEELAND III D.C.
Practice Location Address:

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1740381318 — DR. DONNA M KNEELAND D.C.
Practice Location Address:

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1083702211 — MR. CHRISTOPHER PIERCE MSPT, CSCS
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1255415881 — BALANCE REHABILITATION AND HEALTH SCIENCE, LLC
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Directions to “ MARYANNE CORMIER DC” Practice Location

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