Provider Demographics
NPI:1245402106
Name:CHAPMAN, JUSTIN A (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:A
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1600
Mailing Address - Country:US
Mailing Address - Phone:414-967-9000
Mailing Address - Fax:414-967-9002
Practice Address - Street 1:4433 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-1600
Practice Address - Country:US
Practice Address - Phone:414-967-9000
Practice Address - Fax:414-967-9002
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4390-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor