MY LIFE WELL ADJUSTED LLC (NPI# 1699264143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699264143 |
| Entity Type | Organization |
| Organization Name | MY LIFE WELL ADJUSTED LLC |
| Other Organization Name | BANGOR FAMILY CHIROPRACTIC |
| Practice Address |
268 State St Ste 1 Bangor ME 04401-5417 |
| Mailing Address |
164 Main St Ste 3 Richmond ME 04357-4036 |
| Practice Telephone | 2073077513 |
| Practice Fax Number | 2073077553 |
| Mailing Telephone | 2077372482 |
| Mailing Fax Number | 2077372484 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-09-27 |
| Authorized Official Name | DR. JEFFREY SLOCUM (OWNER) |
| Authorized Official Telephone | 2073077513 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CR912 | ME | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 132180000 | 05 |
| Other Name | Type Code |
|---|---|
| Bangor Family Chiropractic | Doing Business As Name - Organization |
| Street Address |
268 STATE ST STE 1 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-5417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174096309 | Vanidestine Chiropractic, Inc | Chiropractor | 336 Mount Hope Ave Ste 11, Bangor, ME 04401-4236 | 2019-01-10 |
| 1205306503 | Daniel Luigi Comunale | Chiropractor | 622 Fox Gap Rd, Bangor, PA 18013-5833 | 2018-11-29 |
| 1598079873 | Nathan Bryan Roberts | Chiropractor | 125 W Monroe St, Bangor, MI 49013-1332 | 2010-07-29 |
| 1558699314 | Rickie Lane Ames | Chiropractor | 804 Stillwater Ave, Bangor, ME 04401-3614 | 2009-12-05 |
| 1912167057 | Healthsource of Bangor S C | Chiropractor | 1505 Commercial St, Bangor, WI 54614-0410 | 2008-06-12 |
| 1174652291 | Jack Anthony Manzella | Chiropractor | 1505 Commercial St., Bangor Family Chiropractic, Bangor, WI 54614 | 2007-03-05 |
| 1154469047 | Richard J Thomas | Chiropractor | 804 Stillwater Avenue, Bangor, ME 04401 | 2007-02-02 |
| 1164438917 | Robin William Gooden | Chiropractor | 16 Penn Plz, Ste 22, Bangor, ME 04401-3620 | 2006-08-01 |
| 1912911371 | Richard J Weaver | Chiropractor | 83 Bangor Junction Road, Blue Valley Plaza, Bangor, PA 18013 | 2006-07-28 |
| 1841219029 | Richard M. Bruns | Chiropractor | 371 Union St, Bangor, ME 04401-4504 | 2006-07-19 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.