Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 0060000734 | VT |
NPI | 1013097716 |
---|---|
Provider Name | Dr. Maurice Joseph Cyr |
First Address | Rutland, VT 05701 |
Second Address | Rutland, VT 05701-4621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 31/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T25350 | (02) | VT |
VT2507 | BCBS (01) | VT |
VT2507 | MEDICARE LEGACY (01) | VT |