Ultimate Clinic Llc | |
1437 Sams Dr Ste 122 Chesapeake VA 23320-4587 | |
(757) 549-3668 | |
Not Available |
Full Name | Ultimate Clinic Llc |
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Speciality | Clinic/Center |
Location | 1437 Sams Dr Ste 122, Chesapeake, Virginia |
Authorized Official Name and Position | Ryan Sadinski (PARTENER) |
Authorized Official Contact | 7575376050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ultimate Clinic Llc 1437 Sams Dr Ste 122 Chesapeake VA 23320-4587 Ph: (757) 549-3668 | Ultimate Clinic Llc 1437 Sams Dr Ste 122 Chesapeake VA 23320-4587 Ph: (757) 549-3668 |
NPI Number | 1023640349 |
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Provider Enumeration Date | 02/05/2020 |
Last Update Date | 03/09/2020 |
Medicare PECOS PAC ID | 4587092762 |
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Medicare Enrollment ID | O20200323000485 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023640349 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
261QP3300X | Clinic/center - Pain | (* (Not Available)) | Secondary |
Provider Name | Kevin Chou |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609859834 PECOS PAC ID: 4880738509 Enrollment ID: I20100218000883 |
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