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General NPI Number Information
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NPI Number | 1275957995
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Entity Type | Organization
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Legal Business Name | GLENN P CHAPMAN II DC LLC
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Dates
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Enumeration Date | 02/17/2014
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Last Update Date | 02/17/2014
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Provider Practice Location Address
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Address Line | 312 W 3RD ST
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City | PORT CLINTON
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State | OH
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Zip | 43452-1846
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Country | US
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Telephone | 419-734-6250
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Fax | 419-734-5312
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Provider Business Mailing Address
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Address Line | 312 W 3RD ST
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City | PORT CLINTON
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State | OH
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Zip | 43452-1846
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Country | US
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Telephone | 419-734-6250
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Fax | 419-734-5312
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLENN P CHAPMAN II
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Credential | D.C.
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Telephone | 419-734-6250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2290
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License Number State | OH
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