Provider Demographics
NPI:1881835965
Name:CARLUCCIO, DANIEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:CARLUCCIO
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 1:4651 WOODSTOCK RD
Mailing Address - Street 2:#208-311
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1698
Mailing Address - Country:US
Mailing Address - Phone:404-932-9385
Mailing Address - Fax:770-720-7316
Practice Address - Street 1:4651 WOODSTOCK RD
Practice Address - Street 2:#208-311
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1698
Practice Address - Country:US
Practice Address - Phone:404-932-9385
Practice Address - Fax:770-720-7316
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIROO2014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor