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VANIDESTINE CHIROPRACTIC INC NPI 1174096309


NPI Information

NPI: 1174096309
Provider Name: VANIDESTINE CHIROPRACTIC, INC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
336 MOUNT HOPE AVE STE 11
BANGOR, ME
ZIP 04401
Phone: (207) 942-2800
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VANIDESTINE CHIROPRACTIC, INC is a chiropractor in Bangor, ME. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. VANIDESTINE CHIROPRACTIC, INC NPI is 1174096309. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

336 MOUNT HOPE AVE STE 11
BANGOR, ME
ZIP 04401-236
Phone: (207) 942-2800
Fax: (207) 990-2632

The provider's authorized official is Thomas J Vanidestine .
The authorized official title is Owner and has the following contact phone number (207) 942-2800.

The enumeration date for this NPI number is 1/10/2019 and was last updated on 1/10/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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