Organization
BRIDGTON CHIROPRACTIC CENTER, INC.
Active
Organization
BRIDGTON CHIROPRACTIC CENTER, INC.
Active
Other names
Estabrook Sulloway, D.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEWART ESTABROOK SULLOWAY D.C. (DOCTOR OF CHIROPRACTIC, PRESIDENT)
(207) 647-3504
Entity
Organization
Contact information
Practice address
55 PORTLAND RD, BRIDGTON, ME 04009-1230
(207) 647-3504
(207) 647-5862
Mailing address
55 PORTLAND RD, BRIDGTON, ME 04009-1230
(207) 647-3504
(207) 647-5862
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CR755
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039429
ANTHEM/BCBS #
ME
01
—
234252
AETNA #
—
01
—
M20915
CIGNA #
—
Enumeration date
08/08/2006
Last updated
08/22/2020
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