Provider Demographics
NPI:1023515178
Name:OPSAL, CHAD M (DC)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:M
Last Name:OPSAL
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 1:1400 GULF SHORE BLVD N STE 134
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-4971
Mailing Address - Country:US
Mailing Address - Phone:239-778-8114
Mailing Address - Fax:
Practice Address - Street 1:1400 GULF SHORE BLVD N STE 134
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-4971
Practice Address - Country:US
Practice Address - Phone:239-778-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor