Provider Demographics
NPI:1669514394
Name:SCULL, JOSEPH FRANKLIN JR (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANKLIN
Last Name:SCULL
Suffix:JR
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PINEHURST CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3223
Mailing Address - Country:US
Mailing Address - Phone:925-829-8050
Mailing Address - Fax:
Practice Address - Street 1:4247 ROSEWOOD DR
Practice Address - Street 2:18B
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3488
Practice Address - Country:US
Practice Address - Phone:925-737-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26488111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician