Individual
TRISTAN ALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
164 MAIN ST STE 3, RICHMOND, ME 04357-4036
(207) 737-2482
Mailing address
4 UNION PARK RD OFC 18, TOPSHAM, ME 04086-1711
(207) 200-3257
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR2886
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881948768
MEDICARE
ME
05
—
1881948768
—
ME
Enumeration date
02/09/2023
Last updated
01/30/2024
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