Basic Information
| Provider Information | |||||||||
| NPI: | 1528154630 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTARSIERI | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2103 E PARHAM RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HENRICO | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232282235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045012280 | ||||||||
| FaxNumber: | 8045012281 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 W 11TH ST | ||||||||
| Address2: | |||||||||
| City: | SILVER CITY | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880615136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753881511 | ||||||||
| FaxNumber: | 5753138236 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 10/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 10402693 | VA | N | Chiropractic Providers | Chiropractor | 111N00000X | DC2183 | NM | Y | Chiropractic Providers | Chiropractor |
ID Information
| ID | Type | State | Issuer | Description | 6896328 | 01 | VA | CIGNA | OTHER | VV4961A | 01 | VA | MEDICARE PTAN | OTHER |