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Organization
ACTIVE CHIROPRACTIC LIMITED LIABILITY COMPANY PA
Active
Organization
ACTIVE CHIROPRACTIC LIMITED LIABILITY COMPANY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT THOMAS REICHE DC (OWNER)
(207) 571-8028
Entity
Organization
Contact information
Practice address
439 MAIN ST, SUITE 104, SACO, ME 04072-1528
(207) 571-8028
(866) 213-8207
Mailing address
439 MAIN ST, SUITE 104, SACO, ME 04072-1528
(207) 571-8028
(866) 213-8207
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR1313
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020752
MEDICARE PTAN
ME
01
—
022530
BLUE CROSS BLUE SHIELD
ME
01
—
05Z044016ME02
FEDERAL EMPLOYEE PLANS
ME
01
—
U56702
HARVARD PILGRAM
ME
Enumeration date
11/01/2006
Last updated
07/08/2015
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