Provider Demographics
NPI:1255113114
Name:CASPANI CHIROPRACTIC - RENOVO HEALTH & WELLNESS INC.
Entity type:Organization
Organization Name:CASPANI CHIROPRACTIC - RENOVO HEALTH & WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICCOLO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASPANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-322-1026
Mailing Address - Street 1:892 52ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3240
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2914 DOMINGO AVE STE B
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2454
Practice Address - Country:US
Practice Address - Phone:510-322-1026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty