Healthcare Provider Details

I. General information

NPI: 1700863800
Provider Name (Legal Business Name): ROBERT CAPRILE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 MAPLE STREET
EAST LONGMEADOW MA
01028-2753
US

IV. Provider business mailing address

181 MAPLE STREET
EAST LONGMEADOW MA
01028-2753
US

V. Phone/Fax

Practice location:
  • Phone: 413-525-6293
  • Fax: 413-525-8817
Mailing address:
  • Phone: 413-525-6293
  • Fax: 413-525-8817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1630
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: