Provider Demographics
NPI:1033595707
Name:CHAPMAN, MARK R JR (COF)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:CHAPMAN
Suffix:JR
Gender:M
Credentials:COF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10931 E INDEPENDENCE BLVD STE M
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5057
Mailing Address - Country:US
Mailing Address - Phone:704-844-8234
Mailing Address - Fax:704-973-0696
Practice Address - Street 1:10931 E INDEPENDENCE BLVD STE M
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5057
Practice Address - Country:US
Practice Address - Phone:704-844-8234
Practice Address - Fax:704-973-0696
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter