Healthcare Provider Details

I. General information

NPI: 1851335541
Provider Name (Legal Business Name): WILLIAM J SOPCHAK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 FREDLE DR SUITE 230
CONCORD TWP OH
44077-9416
US

IV. Provider business mailing address

7555 FREDLE DR SUITE 230
CONCORD TWP OH
44077-9416
US

V. Phone/Fax

Practice location:
  • Phone: 440-352-0444
  • Fax: 440-352-0456
Mailing address:
  • Phone: 440-352-0444
  • Fax: 440-352-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1823
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: