Provider Demographics
NPI:1922374131
Name:ORCHARD SQUARE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:ORCHARD SQUARE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAPOWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-547-1110
Mailing Address - Street 1:1528 VOLVO PKWY
Mailing Address - Street 2:STE C
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1514
Mailing Address - Country:US
Mailing Address - Phone:757-547-1110
Mailing Address - Fax:757-547-7740
Practice Address - Street 1:1528 VOLVO PKWY
Practice Address - Street 2:STE C
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1514
Practice Address - Country:US
Practice Address - Phone:757-547-1110
Practice Address - Fax:757-547-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
350000475Medicare PIN