Healthcare Provider Details

I. General information

NPI: 1417929266
Provider Name (Legal Business Name): ERIC C SANTJER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KEMPSVILLE RD SUITE ONE
CHESAPEAKE VA
23320-3715
US

IV. Provider business mailing address

115 KEMPSVILLE RD SUITE ONE
CHESAPEAKE VA
23320-3715
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-2045
  • Fax: 757-547-2027
Mailing address:
  • Phone: 757-547-2045
  • Fax: 757-547-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104000885
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: