Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 01-04546 | KS |
Y | 111N00000X | Chiropractor | CR2252 | ME |
N | 111NR0400X | Rehabilitation Chiropractor | 10690 | TX |
NPI | 1043310980 |
---|---|
Provider Name | David James Metcalf |
First Address | Winthrop, ME 04364 |
Second Address | Winthrop, ME 04364-3821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 30/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100327400A | (05) | KS |
U73776 | (02) |