Provider Demographics
NPI:1134789332
Name:CAPITAL CHIROPRACTIC AND PAIN MANAGEMENT
Entity type:Organization
Organization Name:CAPITAL CHIROPRACTIC AND PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:LUCA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-503-5910
Mailing Address - Street 1:833 CASS STREET 1ST FLOOR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611
Mailing Address - Country:US
Mailing Address - Phone:609-503-5910
Mailing Address - Fax:609-503-5528
Practice Address - Street 1:833 CASS STREET 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611
Practice Address - Country:US
Practice Address - Phone:609-503-5910
Practice Address - Fax:609-503-5528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty