Provider Demographics
NPI:1649335159
Name:CAPITOL CHIROPRACTIC INC.
Entity type:Organization
Organization Name:CAPITOL CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:DECUBELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-521-1900
Mailing Address - Street 1:143 WESTMINSTER ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-2017
Mailing Address - Country:US
Mailing Address - Phone:401-521-1900
Mailing Address - Fax:401-828-3003
Practice Address - Street 1:143 WESTMINSTER ST
Practice Address - Street 2:SUITE 303
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2017
Practice Address - Country:US
Practice Address - Phone:401-521-1900
Practice Address - Fax:401-828-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty