Provider Demographics
NPI:1013101302
Name:CHANCE, ROBERT PATRICK (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:CHANCE
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 1:3249 MT DIABLO CT STE 102
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4039
Mailing Address - Country:US
Mailing Address - Phone:925-952-4222
Mailing Address - Fax:
Practice Address - Street 1:3249 MT DIABLO CT STE 102
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4039
Practice Address - Country:US
Practice Address - Phone:925-952-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor