Provider Demographics
NPI:1245429893
Name:DUCA CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:DUCA CHIROPRACTIC, INC
Other - Org Name:BACK ON TRACK CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-942-4243
Mailing Address - Street 1:225 LAKESHORE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 LAKESHORE PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-7108
Practice Address - Country:US
Practice Address - Phone:205-942-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000045070Medicare PIN