Individual
GARRY G BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
96 INDIA ST, PORTLAND, ME 04101-4230
(207) 775-6782
Mailing address
96 INDIA ST, PORTLAND, ME 04101-4230
(207) 775-6782
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR1160
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038957
ANTHEM
ME
01
—
2943218
AETNA
ME
01
—
8504386
CIGNA
ME
Enumeration date
08/10/2006
Last updated
07/08/2007
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