Provider Demographics
NPI:1992919617
Name:COMPREHENSIVE CHIROPRACTIC CARE P.A.
Entity type:Organization
Organization Name:COMPREHENSIVE CHIROPRACTIC CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-773-6425
Mailing Address - Street 1:554 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5407
Mailing Address - Country:US
Mailing Address - Phone:207-773-6425
Mailing Address - Fax:
Practice Address - Street 1:554 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5407
Practice Address - Country:US
Practice Address - Phone:207-773-6425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001807OtherANTHEM BCBS
ME001807OtherANTHEM BCBS
MET31300Medicare UPIN