Provider Demographics
NPI:1942244181
Name:CYR, MICHAEL KENNETH (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KENNETH
Last Name:CYR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CENTER ST.
Mailing Address - Street 2:P.O. BOX 3306
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04212-3306
Mailing Address - Country:US
Mailing Address - Phone:207-784-5120
Mailing Address - Fax:207-786-8150
Practice Address - Street 1:155 CENTER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-5204
Practice Address - Country:US
Practice Address - Phone:207-784-5120
Practice Address - Fax:207-786-8150
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECY015296Medicare ID - Type Unspecified
MET31445Medicare UPIN