Provider Demographics
NPI:1598843880
Name:CAPPS, LOLA JUANITA (DC)
Entity Type:Individual
Prefix:DR
First Name:LOLA
Middle Name:JUANITA
Last Name:CAPPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22305-2712
Mailing Address - Country:US
Mailing Address - Phone:703-535-7881
Mailing Address - Fax:703-535-7882
Practice Address - Street 1:3140 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22305-2712
Practice Address - Country:US
Practice Address - Phone:703-535-7881
Practice Address - Fax:703-535-7882
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG02187C01Medicare ID - Type Unspecified