Provider Demographics
NPI:1861444705
Name:JENKINS, CHAD EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:EDWARD
Last Name:JENKINS
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 1:1409 KEMPSVILLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8134
Mailing Address - Country:US
Mailing Address - Phone:757-410-2793
Mailing Address - Fax:757-410-2807
Practice Address - Street 1:1409 KEMPSVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-8134
Practice Address - Country:US
Practice Address - Phone:757-410-2793
Practice Address - Fax:757-410-2807
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor