Organization
BACK IN MOTION, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CORBETT (BILLING REPRESENTATIVE)
(207) 497-2996
Entity
Organization
Contact information
Practice address
66 MAIN ST, MILBRIDGE, ME 04658
(207) 497-2996
(207) 497-3467
Mailing address
PO BOX 157, MILBRIDGE, ME 04658-0157
(207) 497-2996
(207) 497-3467
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
55820
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098672
BCBS
ME
05
—
210390000
—
ME
01
—
2467127
AETNA
ME
01
—
2485306
AETNA
ME
01
—
350052171
RAILROAD MEDICARE
ME
01
—
M183695
CIGNA
ME
01
—
MN4133
HARVARD PILGRIM
ME
Enumeration date
04/09/2007
Last updated
02/02/2012
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