Provider Demographics
NPI:1467402362
Name:CHADLEY INC
Entity Type:Organization
Organization Name:CHADLEY INC
Other - Org Name:CORRECTIVE CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:LAURENCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-234-1115
Mailing Address - Street 1:7503 A LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9593
Mailing Address - Country:US
Mailing Address - Phone:302-234-1115
Mailing Address - Fax:302-234-6661
Practice Address - Street 1:7503 A LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9593
Practice Address - Country:US
Practice Address - Phone:302-234-1115
Practice Address - Fax:302-234-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01606C01OtherMEDICARE INDIVIDUAL PETAN
DE1669422564OtherNPI TYPE ONE
DE1467402362OtherGROUP NPI
G01606C01OtherMEDICARE INDIVIDUAL PETAN
DE1669422564OtherNPI TYPE ONE