person
Dr. Thomas J Vanidestine JR., DC,CCSP
Chiropractor in Bangor, Maine
NPI 1538108022

Thomas J Vanidestine JR. is a Chiropractor based in Bangor, ME. Thomas J Vanidestine JR. practices in Bangor, ME and has the professional credentials of DC,CCSP. The NPI Number for Thomas J Vanidestine JR. is 1538108022 and holds a License No. CR814 (Maine).

The current practice location address for Thomas J Vanidestine JR. is 336 Mount Hope Ave, Bangor, ME and can be reached out via phone at 207-942-2800 and via fax at 207-990-2362.

Location: 336 Mount Hope Ave, Bangor, ME, 04401-4236
person
Provider Profile Details
NPI Number
1538108022
Provider Name
Thomas J Vanidestine JR.
Credential
DC,CCSP
Provider Entity Type
Individual
Gender
Male
Address
336 Mount Hope Ave, Bangor, ME, 04401-4236
Phone Number
207-942-2800
Fax Number
207-990-2362
Provider Enumeration Date
06/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001039 01 ME BLUE CROSS/ANTHEM
121660000 05 ME
121660099 05 ME
5734579 01 ME CIGNA
5314274 01 ME AETNA
P00282285 01 ME RAILROAD MEDICARE
610664 01 ME GREAT WEST/ACN
68974 01 ME FIRST HEALTH
MN0080 01 ME HARVARD PILGRIM
institution
Provider Business Practice Location Address Details
Address
336 Mount Hope Ave
City
State
Zip
04401-4236
Phone Number
207-942-2800
Fax Number
207-990-2362
person
Provider Business Mailing Address Details
Address
336 Mount Hope Ave
City
State
Zip
04401-4236
Phone Number
207-942-2800
Fax Number
207-990-2362
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
License No.
CR814 (Maine)
Definition
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.
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