Provider Demographics
NPI:1356684393
Name:CHAPIN, TYLER J (DC)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:J
Last Name:CHAPIN
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 1:4705 CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-4103
Mailing Address - Country:US
Mailing Address - Phone:386-763-2718
Mailing Address - Fax:386-763-2719
Practice Address - Street 1:144 YORK RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4521
Practice Address - Country:US
Practice Address - Phone:215-675-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12930111N00000X
PADC010719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor