Provider Demographics
NPI:1235354226
Name:PAOLUCCI, P A
Entity Type:Individual
Prefix:DR
First Name:P
Middle Name:A
Last Name:PAOLUCCI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18901 E MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3475
Mailing Address - Country:US
Mailing Address - Phone:720-851-0600
Mailing Address - Fax:720-851-0508
Practice Address - Street 1:18901 E MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3475
Practice Address - Country:US
Practice Address - Phone:720-851-0600
Practice Address - Fax:720-851-0508
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor