Provider Demographics
NPI:1811207749
Name:LOTURCO, JACOB PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:PAUL
Last Name:LOTURCO
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 1:255 UNION BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1899
Mailing Address - Country:US
Mailing Address - Phone:720-476-5121
Mailing Address - Fax:720-476-5121
Practice Address - Street 1:255 UNION BLVD STE 330
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1899
Practice Address - Country:US
Practice Address - Phone:720-476-5121
Practice Address - Fax:720-476-5121
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7271111NX0800X
NYX012063-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111N00000XChiropractic ProvidersChiropractor