Basic Information
| Provider Information | |||||||||
| NPI: | 1346243540 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TEMPLE | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11680 | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235170680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574223000 | ||||||||
| FaxNumber: | 7576272923 | ||||||||
| Practice Location | |||||||||
| Address1: | 951 W 21ST ST | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235171534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7576230867 | ||||||||
| FaxNumber: | 7576272923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 10/04/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 0104000392 | VA | Y | Chiropractic Providers | Chiropractor |
No ID Information.