Provider Demographics
NPI:1215091053
Name:SAVVAS CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:SAVVAS CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:SAVVAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:757-481-9221
Mailing Address - Street 1:1432 N GREAT NECK RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1342
Mailing Address - Country:US
Mailing Address - Phone:757-481-9221
Mailing Address - Fax:
Practice Address - Street 1:1432 N GREAT NECK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-1342
Practice Address - Country:US
Practice Address - Phone:757-481-9221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000044Medicare PIN