Healthcare Provider Details

I. General information

NPI: 1740322932
Provider Name (Legal Business Name): JAMES PATRICK DAQUILA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 TURNER AVE
RIVERSIDE RI
02905-4433
US

IV. Provider business mailing address

9 TURNER AVE
RIVERSIDE RI
02905
US

V. Phone/Fax

Practice location:
  • Phone: 401-433-5559
  • Fax: 401-437-9436
Mailing address:
  • Phone: 401-433-5559
  • Fax: 401-437-9436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP00256
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: