Provider Demographics
NPI:1598976813
Name:DRALUCK, DEAN ELLIOT (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ELLIOT
Last Name:DRALUCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DEAN
Other - Middle Name:ELLIOT
Other - Last Name:DRALUCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:8036 DANCING WIND LN
Mailing Address - Street 2:807
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3370
Mailing Address - Country:US
Mailing Address - Phone:239-580-8098
Mailing Address - Fax:239-325-8267
Practice Address - Street 1:2067 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2100
Practice Address - Country:US
Practice Address - Phone:239-325-8256
Practice Address - Fax:239-325-8267
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor