Healthcare Provider Details

I. General information

NPI: 1811207749
Provider Name (Legal Business Name): JACOB PAUL LOTURCO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 UNION BLVD STE 330
LAKEWOOD CO
80228-1899
US

IV. Provider business mailing address

255 UNION BLVD STE 330
LAKEWOOD CO
80228-1899
US

V. Phone/Fax

Practice location:
  • Phone: 720-476-5121
  • Fax: 720-476-5121
Mailing address:
  • Phone: 720-476-5121
  • Fax: 720-476-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number7271
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX012063-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: