Organization
NORTHEAST CHIROPRACTIC CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE P DE MAERTELAERE DC (DR/CEO)
(207) 990-5711
Entity
Organization
Contact information
Practice address
304 HANCOCK ST, SUITE 2G, BANGOR, ME 04401-6573
(207) 990-5711
(207) 990-5712
Mailing address
304 HANCOCK ST, 2G, BANGOR, ME 04401-6573
(207) 990-5711
(207) 990-5712
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CR739
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122650099
—
ME
Enumeration date
05/16/2011
Last updated
07/08/2011
Update your record
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