Provider Demographics
NPI:1427200260
Name:DUPUIS, CHAD JOSEPH (LAC, MAC)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:JOSEPH
Last Name:DUPUIS
Suffix:
Gender:M
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-1428
Mailing Address - Country:US
Mailing Address - Phone:423-521-0480
Mailing Address - Fax:
Practice Address - Street 1:822 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1428
Practice Address - Country:US
Practice Address - Phone:423-521-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist