Provider Demographics
NPI:1821194648
Name:CAPORGNO, JOE W (DC)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:W
Last Name:CAPORGNO
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 1:3609 OAKDALE RD
Mailing Address - Street 2:SIUTE 5
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-0718
Mailing Address - Country:US
Mailing Address - Phone:209-551-8888
Mailing Address - Fax:209-551-0412
Practice Address - Street 1:3609 OAKDALE RD
Practice Address - Street 2:SIUTE 5
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95357-0718
Practice Address - Country:US
Practice Address - Phone:209-551-8888
Practice Address - Fax:209-551-0412
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor