Individual
PRISCILLA MARIE SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
10 FOREST FALLS DR, SUITE 3, YARMOUTH, ME 04096-6936
(207) 846-1481
(207) 846-7812
Mailing address
10 FOREST FALLS DR, SUITE 3, YARMOUTH, ME 04096-6936
(207) 846-1481
(207) 846-7812
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
831
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010462305001
FEDERAL TAX ID
ME
01
—
014270
ANTHEM STAR #
ME
01
—
3783182
AETNA PROVIDER #
ME
01
—
MNT457
HARVARD PILGRIM ID #
ME
Enumeration date
02/21/2007
Last updated
07/08/2007
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