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General NPI Number Information
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NPI Number | 1891236139
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Entity Type | Individual
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Provider Name | CHAD ALAN VERMEULEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 920 S MILLEDGE AVE
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City | ATHENS
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State | GA
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Zip | 30605-1334
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Country | US
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Telephone | 706-546-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 245 WOODCREST DR
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City | ATHENS
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State | GA
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Zip | 30606-2337
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Country | US
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Telephone | 605-770-6894
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1310
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10421
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License Number State | GA
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