MEDICARE: DR. THEODORE S SAVVAS JR. D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104000419	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0101000419	OTHER	VA	STATE LICENSE

General Provider Information

NPI Number	:	1205845013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE S SAVVAS JR. D.C.

Provider Business Mailing Address
First Line	:	1432 N GREAT NECK RD
Second Line	:	SUITE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-1342
Country	:	US
Telephone Number	:	757-481-9221
Fax Number	:	757-481-0854

Provider Business Practice Location Address
First Line	:	1432 N GREAT NECK RD
Second Line	:	SUITE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-1342
Country	:	US
Telephone Number	:	757-481-9221
Fax Number	:	757-481-0854

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/27/2013

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