Provider Demographics
NPI:1467664599
Name:CHIPLEY CHIROPRACTIC
Entity Type:Organization
Organization Name:CHIPLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-252-0200
Mailing Address - Street 1:409 N KANAWHA ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801
Mailing Address - Country:US
Mailing Address - Phone:304-252-0200
Mailing Address - Fax:304-252-0256
Practice Address - Street 1:409 N KANAWHA ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-252-0200
Practice Address - Fax:304-252-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV626111N00000X
WV778111N00000X
WV588111N00000X
WV858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CH9298282Medicare ID - Type Unspecified