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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