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Bridgton Chiropractic Center, Inc.

Organization Active NPI Sports Physician Chiropractor · Bridgton, ME

NPI 1790795193 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1790795193
Entity type
Organization (NPI type 2)
Primary specialty
Sports Physician Chiropractor 111NS0005X
License
CR755 (ME)
Legal business name
BRIDGTON CHIROPRACTIC CENTER, INC.
Practice address
55 Portland Rd
Bridgton, ME 04009-1230
Phone
(207) 647-3504
Fax
(207) 647-5862
NPI assigned
Aug 8, 2006
Organization subpart
No

Authorized official

Name
Dr. Stewart Estabrook Sulloway, D.C.
Title
Doctor of Chiropractic, President
Phone
(207) 647-3504

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

55 Portland Rd
Bridgton, ME 04009
Phone (207) 647-3504

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP		 111NS0005X CR755 ME Yes

Addresses

Primary practice location

55 Portland Rd
Bridgton, ME 04009-1230

Mailing address

55 Portland Rd
Bridgton, ME 04009-1230
Phone (207) 647-3504

Other identifiers

IdentifierTypeStateIssuer
M20915OtherCIGNA #
234252OtherAETNA #
039429OtherMEANTHEM/BCBS #

Other names

  • Estabrook Sulloway, D.C. Other name

Other providers in Bridgton, ME

All providers in Bridgton, ME · Sports Physician Chiropractor in Maine

Sources for this page

Verify at the official NPI Registry.