Healthcare Provider Details

I. General information

NPI: 1962656934
Provider Name (Legal Business Name): ATLANTIC CHIROPRACTIC AND REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 11/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KEMPSVILLE RD STE. 1
CHESAPEAKE VA
23320-3857
US

IV. Provider business mailing address

115 KEMPSVILLE RD SUITE ONE
CHESAPEAKE VA
23320-3857
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 TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number885
License Number StateVA

VIII. Authorized Official

Name: DR. ERIC CARL SANTJER
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 757-547-2045