Provider Demographics
NPI:1528679875
Name:CHAO, RAYMOND (ND, DC, LAC)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:CHAO
Suffix:
Gender:M
Credentials:ND, DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 NEW TOWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7088
Mailing Address - Country:US
Mailing Address - Phone:704-843-5045
Mailing Address - Fax:
Practice Address - Street 1:8420 NEW TOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-7088
Practice Address - Country:US
Practice Address - Phone:704-843-5045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171100000X
WA175F00000X
NC5815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath