Provider Demographics
NPI:1427031814
Name:SLADE BRIER, KIMBERLY A (DC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:SLADE BRIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HOOPER ST
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-4053
Mailing Address - Country:US
Mailing Address - Phone:207-882-7600
Mailing Address - Fax:207-882-4212
Practice Address - Street 1:49 HOOPER ST
Practice Address - Street 2:
Practice Address - City:WISCASSET
Practice Address - State:ME
Practice Address - Zip Code:04578-4053
Practice Address - Country:US
Practice Address - Phone:207-882-7600
Practice Address - Fax:207-882-4212
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1489568OtherCIGNA
ME048052OtherANTHEM BLUE CROSS
ME3822616OtherAETNA
ME048052OtherANTHEM BLUE CROSS
ME1489568OtherCIGNA