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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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