My Life Well Adjusted LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CR912 Issued in ME

Legal business name

MY LIFE WELL ADJUSTED LLC

Practice address

268 State St Ste 1
Bangor, ME 04401-5417

Phone

(207) 307-7513

Fax

(207) 307-7553

NPI assigned

May 9, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Slocum, DC

Title

Owner

Phone

(207) 307-7513

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bangor Family Chiropractic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1699264143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 MAIN ST STE 3",
            "city": "RICHMOND",
            "state": "ME",
            "postal_code": "043574036",
            "telephone_number": "207-737-2482",
            "fax_number": "207-737-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STATE ST STE 1",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015417",
            "telephone_number": "207-307-7513",
            "fax_number": "207-307-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY LIFE WELL ADJUSTED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "SLOCUM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-307-7513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132180000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bangor Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bangor Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon Murray, LCSW
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• Katelyn Cyr Musinski, DPT
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• Heath Myers, LCSW
• Leta Myers, LCSW
• Mollie Ruth Myers, MD
• Farbod Nabizadeh, MD
• Kenneth G Nadeau, PAC

• Chiropractor in Bangor, ME
• Providers in Bangor, ME by specialty
• Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.