Provider Demographics
NPI:1578720017
Name:CHIROCARE PLUS, INC.
Entity Type:Organization
Organization Name:CHIROCARE PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GESUALDI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-565-6464
Mailing Address - Street 1:3204 IRONBOUND RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2410
Mailing Address - Country:US
Mailing Address - Phone:757-565-6464
Mailing Address - Fax:757-565-7714
Practice Address - Street 1:3204 IRONBOUND RD
Practice Address - Street 2:SUITE A
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2410
Practice Address - Country:US
Practice Address - Phone:757-565-6464
Practice Address - Fax:757-565-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010400644111N00000X
VA0104000644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1295722940OtherINDIVIDUAL NPI
VA350001235Medicare PIN
VAU17376Medicare UPIN