Provider Demographics
NPI:1851335541
Name:SOPCHAK, WILLIAM J (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:SOPCHAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 FREDLE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9416
Mailing Address - Country:US
Mailing Address - Phone:440-352-0444
Mailing Address - Fax:440-352-0456
Practice Address - Street 1:7555 FREDLE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:CONCORD TWP
Practice Address - State:OH
Practice Address - Zip Code:44077-9416
Practice Address - Country:US
Practice Address - Phone:440-352-0444
Practice Address - Fax:440-352-0456
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1823OtherLICENSE NUMBER
OH341737573OtherTAX ID #
H112680Medicare PIN
OH341737573OtherTAX ID #
OH1823OtherLICENSE NUMBER
OH0734621Medicare ID - Type Unspecified