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General NPI Number Information
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NPI Number | 1922244268
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Entity Type | Individual
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Provider Name | SCOTT MICHAEL KUPER D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/16/2008
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 821 W 21ST ST SUITE 100
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City | NORFOLK
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State | VA
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Zip | 23517-1500
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Country | US
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Telephone | 757-622-1222
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Fax | 757-622-4222
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Provider Business Mailing Address
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Address Line | 2004 SANDBRIDGE RD STE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-4084
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Country | US
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Telephone | 412-606-2069
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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 | 0104556671
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License Number State | VA
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