Provider Demographics
NPI:1508206129
Name:NORTH CHESTERFIELD CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:NORTH CHESTERFIELD CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PAULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-323-0700
Mailing Address - Street 1:2705 BUFORD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2423
Mailing Address - Country:US
Mailing Address - Phone:804-323-0700
Mailing Address - Fax:804-323-0788
Practice Address - Street 1:2705 BUFORD RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-2423
Practice Address - Country:US
Practice Address - Phone:804-323-0700
Practice Address - Fax:804-323-0788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty