Provider Demographics
NPI:1093796773
Name:ERARIO, VINCENT J JR (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:ERARIO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4566 LAWRENCEVILLE HWY NW
Mailing Address - Street 2:#201
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3686
Mailing Address - Country:US
Mailing Address - Phone:770-923-3707
Mailing Address - Fax:770-923-4170
Practice Address - Street 1:4566 LAWRENCEVILLE HWY NW
Practice Address - Street 2:#201
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3686
Practice Address - Country:US
Practice Address - Phone:770-923-3707
Practice Address - Fax:770-923-4170
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA1893111N00000X
FLCH3457111N00000X
IA4763111N00000X
NYX2345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAT97565Medicare UPIN