Organization
OLD ORCHARD BEACH CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY STEPHEN BRYANT III D.C. (OWNER)
(207) 934-4600
Entity
Organization
Contact information
Practice address
155 SACO AVE STE A2, OLD ORCHARD BEACH, ME 04064-1600
(207) 934-4600
(207) 934-4606
Mailing address
155 SACO AVE STE A2, OLD ORCHARD BEACH, ME 04064-1600
(207) 934-4600
(207) 934-4606
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR1354
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023110
BLUE CROSS BLUE SHIELD
ME
Enumeration date
05/03/2007
Last updated
01/29/2008
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