Provider Demographics
NPI:1336738301
Name:CHAPP CHIROPRACTIC, P.L.L.C.
Entity type:Organization
Organization Name:CHAPP CHIROPRACTIC, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CHAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-460-4786
Mailing Address - Street 1:9090 S RODGERS CT SE STE B
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-8052
Mailing Address - Country:US
Mailing Address - Phone:616-460-4786
Mailing Address - Fax:
Practice Address - Street 1:9090 S RODGERS CT SE STE B
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-8052
Practice Address - Country:US
Practice Address - Phone:616-698-6981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIJC008146OtherBLUE CROSS BLUE SHIELD
MI900144100OtherPRIORITY HEALTH
MI649492OtherUNITED HEALTH CARE (ACN/UNITED GREAT WEST)
MI649492OtherUNITED HEALTH CARE ACN