Provider Demographics
NPI:1992245781
Name:BUCHANAN, CHAYPIN (LATC)
Entity type:Individual
Prefix:
First Name:CHAYPIN
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12228 ITTA BENA ROAD
Mailing Address - Street 2:
Mailing Address - City:EMORY
Mailing Address - State:VA
Mailing Address - Zip Code:24327
Mailing Address - Country:US
Mailing Address - Phone:276-944-6848
Mailing Address - Fax:
Practice Address - Street 1:12228 ITTA BENA ROAD
Practice Address - Street 2:
Practice Address - City:EMORY
Practice Address - State:VA
Practice Address - Zip Code:24327
Practice Address - Country:US
Practice Address - Phone:276-944-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260024792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer