Provider Demographics
NPI:1467106070
Name:GARCIA-LUGO, LUIS A (DC)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:GARCIA-LUGO
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 1:2013 POWERS FERRY RD SE APT A
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5229
Mailing Address - Country:US
Mailing Address - Phone:787-368-0901
Mailing Address - Fax:
Practice Address - Street 1:5071 PEACHTREE BLVD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2728
Practice Address - Country:US
Practice Address - Phone:687-205-1219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor