Provider Demographics
NPI:1003902412
Name:LAPUCK, ROBERT ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARTHUR
Last Name:LAPUCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 PLEASANT STREET
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:508-588-3322
Mailing Address - Fax:508-587-0411
Practice Address - Street 1:340 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-588-3322
Practice Address - Fax:508-587-0411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA541111N00000X
NH04701520380A111N00000X
FL3426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1604341Medicaid
MA1604341Medicaid