Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CR1368 | ME |
NPI | 1003084104 |
---|---|
Provider Name | Dr. Sara Littlefield Rivard |
First Address | South Portland, ME 04106-2432 |
Second Address | South Portland, ME 04106-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2008 |
Last Update Date | 28/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003084104 | NPI (01) | ME |