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General NPI Number Information
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NPI Number | 1508206129
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Entity Type | Organization
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Legal Business Name | NORTH CHESTERFIELD CHIROPRACTIC, PC
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 2705 BUFORD RD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-2423
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Country | US
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Telephone | 804-323-0700
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Fax | 804-323-0788
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Provider Business Mailing Address
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Address Line | 2705 BUFORD RD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-2423
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Country | US
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Telephone | 804-323-0700
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Fax | 804-323-0788
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON ROBERT PAULMAN
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Credential | DC
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Telephone | 804-323-0700
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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 | 0104556944
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License Number State | VA
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